BENNETT EZRA GOLTZ (P.A.-C) – Physician Assistant, NPI 1588825145
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
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Provider Addresses for BENNETT EZRA GOLTZ (P.A.-C)
3643, Turner Drive Southwest, Spring Lake, Prior Lake, Scott County, Minnesota, 55372, United States
PRIOR LAKE, MN 553724343
Phone: (612) 239-6488
Fax: (952) 924-5994
Type: Mailing
France Avenue South, 44th and France, Edina, Hennepin County, Minnesota, 55431, United States
EDINA, MN 55435
Phone: (952) 924-5030
Fax: (952) 924-5994
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $629.
Total Amount is formed as General ($629) + Research ($0) + Ownership ($0) = $629.
Last reported payment date: 2024-06-28 • Largest payer in this snapshot: Inspire Medical Systems, Inc. ($629).
Total Amount
$629
General + Research + Ownership
Payments
3
Total payment records
General Amount
$629
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inspire Medical Systems, Inc. | $629 |
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: 2008-12-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081212000570 | I | Physician Assistant | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 65 | 64 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 57 | 53 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 49 | 45 | $0 |
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 31 | 31 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 25 | 25 | $0 |
Insurance plans in this area (ZIP 55372)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | MN | |
| G A S T R O E N T E R O L O G Y | MN | |
| N E U R O S U R G E R Y | OH | |
| - | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | OR | |
| Cardiovascular Disease (Cardiology) | IL |
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