Organization Active NPI

Goldrock Medical, P.C.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1053510131
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
220017 Issued in NY
Legal business name
GOLDROCK MEDICAL, P.C.
Practice address
139 Fulton St
# 703
New York, NY 10038-2594
Phone
(212) 406-0128
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Jeremie Rachunow, MD
Title
Owner/President
Phone
(973) 575-7342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 220017 NY Primary

Addresses

Primary practice location

139 Fulton St
# 703
New York, NY 10038-2594

Mailing address

139 Fulton St
# 703
New York, NY 10038-2594
Phone (212) 406-0128

National Provider Directory

National Provider Directory

Locations

139 Fulton St
Rm 703
New York, NY 10038
Phone (212) 406-0127

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1053510131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FULTON ST",
            "address_2": "# 703",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382594",
            "telephone_number": "212-406-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FULTON ST",
            "address_2": "# 703",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382594",
            "telephone_number": "212-406-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDROCK MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "RACHUNOW",
        "authorized_official_first_name": "JEREMIE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "973-575-7342",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "220017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.