Tatiana A Goclowski, MSN, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Bethany, Connecticut. Her current practice location is
187 Beacon Rd, Bethany, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(413) 388-2892.
Tatiana A Goclowski is licensed to practice in Connecticut (license number 12.007735) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1831639392.
Provider's Profile
| Full Name | Tatiana A Goclowski |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 187 Beacon Rd, Bethany, Connecticut |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1831639392
- Provider Enumeration Date: 03/03/2017
- Last Update Date: 06/14/2019
Medicare PECOS Information:
- PECOS PAC ID: 0345526257
- Enrollment ID: I20170407000504
Medical Identifiers
Medical identifiers for Tatiana A Goclowski such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1831639392 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | RN231763 (Massachusetts) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 12.007735 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tatiana A Goclowski allows following entities to bill medicare on her behalf.
| Entity Name | Pioneer Valley Urology, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750315982
PECOS PAC ID: 7214972207
Enrollment ID: O20050621000419 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tatiana A Goclowski is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Tatiana A Goclowski, MSN, FNP-BC
100 Wason Ave Ste 120,
Springfield, MA 01107-1179
Ph: (413) 241-2100 | Tatiana A Goclowski, MSN, FNP-BC
187 Beacon Rd,
Bethany, CT 06524-3054
Ph: (413) 388-2892 |
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