Individual provider Active NPI

Jacob B. Goldstein, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Olathe, KS
National Provider Identifier
1003896374
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
12-00358KS Issued in KS
Practice address
401 S Clairborne Rd Ste 201
Olathe, KS 66062-1735
Phone
(913) 856-8150
Fax
(913) 856-8390
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 12-00358KS KS Primary
Podiatrist 213E00000X MD2185 NJ
Podiatrist 213E00000X 2006023557 MO

Addresses

Primary practice location

401 S Clairborne Rd Ste 201
Olathe, KS 66062-1735

Mailing address

401 S Clairborne Rd Ste 201
Olathe, KS 66062-1735
Phone (913) 856-8150

Other practice location 1

302 S Main St
Ottawa, KS 66067-2332
Phone (913) 856-8150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061016000490 KS Practitioner - Podiatry 8325011539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 S Main St
Ottawa, KS 66067-2332
Phone (913) 856-8150

401 S Clairborne Rd
Suite 201
Olathe, KS 66062-1735
Phone (913) 856-8150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue474
Removal or shaving of skin growth50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2185NJMDPsychologist
2006023557MOMDPodiatrist
MD2185NJMDPodiatrist
12-00358KSKSMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health Providers LLC Past Accepting new patients
Barry J. Gallanter, DPM PA Podiatrist Past Accepting new patients
Brookside Health Services, Inc. PastSince Aug 30, 2010 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1003896374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S CLAIRBORNE RD STE 201",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621735",
            "telephone_number": "913-856-8150",
            "fax_number": "913-856-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S CLAIRBORNE RD STE 201",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621735",
            "telephone_number": "913-856-8150",
            "fax_number": "913-856-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 S Main St",
            "address_purpose": "LOCATION",
            "city": "Ottawa",
            "state": "KS",
            "postal_code": "660672332",
            "country_code": "US",
            "telephone_number": "913-856-8150",
            "fax_number": "913-856-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JACOB",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KS",
            "license": "12-00358KS",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD2185",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "2006023557",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.