Individual provider Active NPI

Michael Joel Goldstein, M.D.

  • Gastroenterology Physician
  • Great Neck, NY
National Provider Identifier
1063410645
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
087746 Issued in NY
Practice address
310 E Shore Rd
206
Great Neck, NY 11023-2432
Phone
(516) 487-7677
Fax
(516) 487-2868
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 087746 NY Primary

Addresses

Primary practice location

310 E Shore Rd
206
Great Neck, NY 11023-2432

Mailing address

310 E Shore Rd
206
Great Neck, NY 11023-2432
Phone (516) 487-7677

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325001058 NY Practitioner - Gastroenterology 0840369823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Healthcare Associates, P.C. Gastroenterology CurrentSince Jul 18, 1979 Accepting new patients
Gastrointestinal Care of Long Island PLLC Gastroenterology PastSince Oct 1, 2024 Accepting new patients

Locations

310 E Shore Rd
Ste 206
Great Neck, NY 11023
Phone (516) 487-7677

Organizations & group practices 2

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1063410645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E SHORE RD",
            "address_2": "206",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232432",
            "telephone_number": "516-487-7677",
            "fax_number": "516-487-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E SHORE RD",
            "address_2": "206",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232432",
            "telephone_number": "516-487-7677",
            "fax_number": "516-487-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MICHAEL",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "087746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.