BRADLEY GOLL – Certified Registered Nurse Anesthetist, NPI 1770121089

BRADLEY GOLL is a healthcare provider. based in Eagle, Idaho. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 50150 (ID). The NPI Number for BRADLEY GOLL is 1770121089

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY GOLL
NPI
1770121089
Phone
Not provided
Address
1073 N HILTONHEAD WAY
Enumeration Date
17 December 2019
Last Update Date
17 December 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3604273625
Graduation Year
2019 (7 years ago)
PAC ID
3476982794
Group Practice PAC ID
0345139275
Professional Enrollment ID
I20200407001733
Address ID
WA985844401SH901XXDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

990 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WA

Provider Addresses for BRADLEY GOLL

  • 1073 N HILTONHEAD WAY

    EAGLE, ID 836165460

    Phone:

    Type: Mailing

  • 810 JASMINE ST

    OMAK, WA 988419578

    Phone: (509) 826-1760

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-04-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200407001733ICertified Registered Nurse Anesthetist (Crna)WATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery3029$0
00811Anesthesia for other procedure on large bowel using an endoscope1313$0
View full utilization report →

Insurance plans in this area (ZIP 83616)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345139275View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)CA
Interventional Cardiology, Cardiovascular Disease (Cardiology), Interventional CardiologyAK
-WA
Certified Registered Nurse Anesthetist (Crna)MN
Physician AssistantVA
O B S T E T R I C S/ G Y N E C O L O G YWA
Physician AssistantWA
Nurse PractitionerPA
Physician AssistantWA
Physician AssistantWA

Reviews

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Frequently asked questions

How is BRADLEY GOLL identified in CMS data?
CMS-hosted NPPES data lists BRADLEY GOLL with NPI 1770121089.
Does the file indicate BRADLEY GOLL is practicing under active NPI?
Directory data currently reports BRADLEY GOLL as active.
What healthcare role does BRADLEY GOLL hold?
Scheduling teams often label BRADLEY GOLL under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is BRADLEY GOLL based?
BRADLEY GOLL is tied to Eagle, Idaho in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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