MS. DENISE ANN GOMOLAK N.P.
NPI 1881705804
Nurse Practitioner - Family in Flagstaff, AZ
About Ms. Denise Ann Gomolak N.p. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. DENISE ANN GOMOLAK N.P. (NPI 1881705804) is an individual family provider in Flagstaff, Arizona, licensed in Arizona (AP1123) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ms. Denise Ann Gomolak N.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Denise Gomolak reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Syracuse, NY 13210
- Reassigned Medicare billing, New York enrollment
- 171 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 86001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 3
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
FLAGSTAFF, AZ 86001
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 Denise Gomolak's NPI number?
The NPI number for Denise Gomolak is 1881705804. It was assigned to this individual provider in the NPPES registry on August 31, 2006.
Where is Denise Gomolak located?
Denise Gomolak practices at 107 E Oak Ave, Flagstaff, AZ 86001. The listed phone number is (928) 913-8800.
What is Denise Gomolak's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Denise Gomolak enrolled in Medicare?
Yes. Denise Gomolak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Denise Gomolak's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Denise Gomolak reassigns Medicare benefits to Psychiatry Faculty Practice, Inc. (Syracuse, NY). The 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 Denise Gomolak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Denise Gomolak was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Ms. Denise Ann Gomolak, N.P. · NPI 1881705804
Family physician in Flagstaff, Arizona. Individual provider, active in the CMS NPPES registry since August 31, 2006.
## Identity
- **NPI:** 1881705804 (Entity type: Individual)
- **Enumerated:** August 31, 2006
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** AP1123 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 107 E OAK AVE, Flagstaff, AZ 86001-1818
- **Phone:** (928) 913-8800 · **Fax:** (928) 913-8801
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Psychiatry Faculty Practice, Inc. (NPI 1881084820, Syracuse, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** March 7, 2023
- **Other identifiers:** Medicaid 910514 (AZ); Medicaid 910514 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1881705804) · Data from the CMS NPPES public registry.