Individual provider Active NPI

Thomas Israel Goldman, D.P.M.

  • Podiatrist
  • New York, NY
National Provider Identifier
1073538443
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005362 Issued in NY
Practice address
450 Park Ave
Suite #2-B
New York, NY 10016-7320
Phone
(212) 679-6776
Fax
(212) 679-6538
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 005362 NY Primary
Foot Surgery Podiatrist 213ES0131X 005362 NY

Addresses

Primary practice location

450 Park Ave
Suite #2-B
New York, NY 10016-7320

Mailing address

450 Park Ave
Suite #2-B
New York, NY 10016-7320
Phone (212) 679-6776

Other identifiers 6

IdentifierTypeStateIssuer
5624704OtherNYAETNA ID
P95263OtherNYBLUE CROSS BLUE SHIELD
04891OtherNYMEDICARE /GHI
6201507OtherNYGHI
3C3513OtherNYHEALTHNET
P2176344OtherNYOXFORD

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001370 NY Practitioner - Podiatry 6709776321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

55 E 34TH St
New York, NY 10016-4337
Phone (212) 252-6131

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue43
Removal of skin lesions1-10
Removal of nail tissue31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005362NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Networks

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

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1073538443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PARK AVE",
            "address_2": "SUITE #2-B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167320",
            "telephone_number": "212-679-6776",
            "fax_number": "212-679-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PARK AVE",
            "address_2": "SUITE #2-B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167320",
            "telephone_number": "212-679-6776",
            "fax_number": "212-679-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "THOMAS",
        "middle_name": "ISRAEL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005362",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "005362",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "5624704",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P95263",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE /GHI",
            "identifier": "04891",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6201507",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3C3513",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2176344",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.