SAMUEL K GOOLDY, MD PC
NPI 1104975036
Family Medicine in New Hartford, NY
About Samuel K Gooldy, Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL K GOOLDY, MD PC (NPI 1104975036) is a healthcare organization registered as a family medicine in New Hartford, New York and active in the NPI registry since January 2007. The organization lists Samuel K Gooldy, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samuel K Gooldy, Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Samuel K Gooldy, MD PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samuel K Gooldy, MD PC's NPI number?
The NPI number for Samuel K Gooldy, MD PC is 1104975036. It was assigned to this organization in the NPPES registry on January 9, 2007.
Where is Samuel K Gooldy, MD PC located?
Samuel K Gooldy, MD PC is located at 1 Oxford Rd Suite 304, New Hartford, NY 13413. The listed phone number is (315) 724-6611.
What is Samuel K Gooldy, MD PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Samuel K Gooldy, MD PC enrolled in Medicare?
Yes. Samuel K Gooldy, MD PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Samuel K Gooldy, MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Samuel K Gooldy, MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Samuel K Gooldy, MD PC was last updated on January 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Samuel K Gooldy, Md Pc · NPI 1104975036
Family Medicine organization in New Hartford, New York. Organization record, active in the CMS NPPES registry since January 9, 2007.
## Identity
- **NPI:** 1104975036 (Entity type: Organization)
- **Enumerated:** January 9, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Samuel Gooldy, PRESIDENT
## Practice location
- **Address:** 1 OXFORD RD, SUITE 304, New Hartford, NY 13413-2651
- **Phone:** (315) 724-6611 · **Fax:** (315) 724-6366
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 16, 2009
- **Other identifiers:** Medicare ID-Type Unspecified 40075A; Medicare ID-Type Unspecified 40075D; Medicaid 00582774 (NY); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1104975036) · Data from the CMS NPPES public registry.