Individual provider Active NPI

Jessica Monroe Goldman, CNM

  • Advanced Practice Midwife
  • Brooklyn, NY
National Provider Identifier
1053454637
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000856 Issued in NY
Practice address
502A 9TH Street
Brooklyn, NY 11215
Phone
(718) 499-3636
Fax
(718) 788-0596
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 509242 NY
Advanced Practice Midwife 367A00000X F000856 NY Primary

Addresses

Primary practice location

502A 9TH Street
Brooklyn, NY 11215

Mailing address

126 Terrace PL
Brooklyn, NY 11218-1104
Phone (917) 863-5382

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address jem9045@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160413000332 NY Practitioner - Certified Nurse Midwife (CNM) 2163720830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kings Physician Services PCGroup PAC ID 0547579427, 643 clinicians

Practice addresses (Care Compare)

9438 58TH Ave
Elmhurst, NY 11373-5149
Phone (718) 393-3900

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as group
Quality
84.67
Promoting interoperability
100
Improvement activities
40
Cost
71.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000856NYMDPsychoanalyst
509242NYMDRegistered Nurse
F000856NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Apr 3, 2019 Accepting new patients
Kings Physician Services, PC CurrentSince Apr 3, 2019 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

1224 8th Ave
Brooklyn, NY 11215
Phone (718) 788-5588

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

126 Hewes St
Lowr
Brooklyn, NY 11211

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

9438 58th Ave
Unit G3
Elmhurst, NY 11373
Phone (718) 393-3900

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

12105 Rockaway Beach Blvd
Rockaway Park, NY 11694
Phone (718) 412-9980

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: jmg9045@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1053454637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 TERRACE PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181104",
            "telephone_number": "917-863-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502A 9TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-499-3636",
            "fax_number": "718-788-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "JESSICA",
        "middle_name": "MONROE",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "509242",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "502A 9th Street",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jem9045@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "502A 9th Street",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "502A 9th Street",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "11215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.