MR. PETER VERNON GOETCHIUS PHYSICIAN ASSISTANT
NPI 1285610451
Physician Assistant - Medical in Fort Drum, NY

Q: What is Peter Goetchius's NPI number?

The NPI number for Peter Goetchius is 1285610451. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Q: What is Peter Goetchius's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Peter Goetchius was last updated on May 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since December 20, 2005PECOS Enrolled

11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN: CREDENTIALS, FORT DRUM, NY 13602(315) 772-4025(315) 772-9498 Get Directions Write a Review

NPPES record last updated: May 20, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Peter Vernon Goetchius Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. PETER VERNON GOETCHIUS PHYSICIAN ASSISTANT (NPI 1285610451) is an individual medical provider in Fort Drum, New York, licensed in New York (000219-0) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285610451

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. PETER VERNON GOETCHIUSCredential: PHYSICIAN ASSISTANT

Location Address11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN: CREDENTIALSFort Drum, NY 13602-5438

Mailing Address11050 Mount Belvedere Blvd, Usa Meddac Attn: CredentialsFort Drum, NY 13602-5438 · (315) 772-4025 · Fax (315) 772-9498

Phone(315) 772-4025

Fax(315) 772-9498

Sole ProprietorNo

Enumeration DateDecember 20, 2005

Last NPPES UpdateMay 20, 2008

✔ NPI 1285610451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NY · 000219-0

11050 MOUNT BELVEDERE BLVD, Fort Drum, NY 13602

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Other Identifiers 1

Medicare UPINVAD000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Peter Vernon Goetchius Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LAUREL JARVIS PH.D.

Psychologist (Clinical)

11050 MOUNT BELVEDERE BLVD, BEHAVIORAL HEALTH DEPARTMENT, MEDDAC
FORT DRUM, NY 13602

Jefferson County (315) 772-4850

DAVID LEWIS KEYES RPA-C

Physician Assistant

11050 MOUNT BELVEDERE BLVD, USA MEDDAC CREDENTIALS
FORT DRUM, NY 13602

Jefferson County (315) 772-5508

BRADY SIMPKINS PA-C

Physician Assistant

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (802) 258-0301

MS. MARY ANGELA MACCULLOCH LCSW

Social Worker (Clinical)

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-7624

DR. ISAAC P MILLS DO

Family Medicine

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-2778

SAVITRI MOTAPARTHI M.D.

Pediatrics

11050 MOUNT BELVEDERE BLVD, USA MEDDAC /CREDENTIALS
FORT DRUM, NY 13602

Jefferson County (315) 772-4025

DR. LUTHER ROSWELL WIEST D.O.

Family Medicine

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-3679

MADISON GERMAN LCSW

Social Worker (Clinical)

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-2778

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 Peter Goetchius's NPI number?

The NPI number for Peter Goetchius is 1285610451. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Where is Peter Goetchius located?

Peter Goetchius practices at 11050 Mount Belvedere Blvd Usa Meddac Attn: Credentials, Fort Drum, NY 13602. The listed phone number is (315) 772-4025.

What is Peter Goetchius's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Peter Goetchius enrolled in Medicare?

Yes. Peter Goetchius is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Peter Goetchius was last updated on May 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.