Individual provider Active NPI

John Matthew Goldfarb, MS CCC SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1073676300
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2464 Issued in NM
Practice address
4210A Louisiana Blvd NE
Albuquerque, NM 87109-1807
Phone
(505) 268-5933
Fax
(505) 268-0184
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2464 NM Primary

Addresses

Primary practice location

4210A Louisiana Blvd NE
Albuquerque, NM 87109-1807

Mailing address

5127 Trevi PL NW
Albuquerque, NM 87114-3809
Phone (505) 890-7798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2464NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073676300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5127 TREVI PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143809",
            "telephone_number": "505-890-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210A LOUISIANA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091807",
            "telephone_number": "505-268-5933",
            "fax_number": "505-268-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "2464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.