Individual provider Active NPI

Jeffrey L Gold, MD

  • Internal Medicine Physician
  • Wayne, NJ
National Provider Identifier
1083641765
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA36557 Issued in NJ
Practice address
468 Parish Dr
Wayne, NJ 07470-4671
Phone
(973) 305-8300
Fax
(973) 305-8157
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA36557 NJ Primary

Addresses

Primary practice location

468 Parish Dr
Wayne, NJ 07470-4671

Mailing address

468 Parish Dr
Wayne, NJ 07470-4671
Phone (973) 686-2777

Other identifiers 1

IdentifierTypeStateIssuer
4798201MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050228000042 NJ Practitioner - Internal Medicine 0446203848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart and Vascular Associates of Northern Jersey, P.a.Group PAC ID 4183610520, 14 clinicians

Practice addresses (Care Compare)

22 -02 Broadway
Suite 201
Fair Lawn, NJ 07410-3016
Phone (201) 475-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA36557NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Healthcare, Inc. Internal Medicine Past Accepting new patients
Medical Associates of Englewood, PC Internal Medicine PastSince Oct 31, 2019 Accepting new patients
Vanguard Medical Group, PA PastSince Oct 1, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/HCEDAD/Endpoint/HCEDAD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1083641765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 PARISH DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704671",
            "telephone_number": "973-686-2777",
            "fax_number": "973-686-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 PARISH DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704671",
            "telephone_number": "973-305-8300",
            "fax_number": "973-305-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA36557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4798201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.