Individual provider Active NPI

Barry Jonathan Goldman, MSPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1063585735
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025483-1 Issued in NY
Practice address
7001 Amboy Rd
Staten Island, NY 10307-1444
Phone
(718) 227-4400
Fax
(718) 227-4401
NPI assigned
Nov 17, 2006
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 025483-1 NY Primary

Addresses

Primary practice location

7001 Amboy Rd
Staten Island, NY 10307-1444

Mailing address

370 Ashland Ave
Staten Island, NY 10309-3056
Phone (347) 886-4062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826000388 NY Practitioner - Physical Therapist in Private Practice 4284609082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7001 Amboy Rd
Staten Island, NY 10307-1444
Phone (718) 227-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025483-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Barry Goldman Physical Therapist PLLC Physical Therapist CurrentSince May 6, 2022 Accepting new patients
Richmond Valley Pharmacy Inc Past Accepting new patients
Richard Bodian,PT Physical Therapist Past Accepting new patients
RB Physical and Occupational Therapy PLLC Physical Therapist PastSince May 10, 2021 Accepting new patients

Locations

7001 Amboy Rd
Staten Island, NY 10307
Phone (347) 838-6991

7001 Amboy Rd
Ste 113
Staten Island, NY 10307

7001 Amboy Rd
Ste C102
Staten Island, NY 10307

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1063585735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 ASHLAND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093056",
            "telephone_number": "347-886-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071444",
            "telephone_number": "718-227-4400",
            "fax_number": "718-227-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "BARRY",
        "middle_name": "JONATHAN",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025483-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.