Individual provider Active NPI

Marc F Goldstein, M.D.

  • Allergy & Immunology Physician
  • Philadelphia, PA
National Provider Identifier
1093863334
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD023998E Issued in PA
Practice address
205 N Broad St
Suite 300
Philadelphia, PA 19107-1554
Phone
(215) 569-1111
Fax
(215) 569-8797
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD023998E PA Primary
Allergy & Immunology Physician 207K00000X 25MA03788500 NJ

Addresses

Primary practice location

205 N Broad St
Suite 300
Philadelphia, PA 19107-1554

Mailing address

205 N Broad St
Suite 300
Philadelphia, PA 19107-1554
Phone (215) 569-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100909000337 NJ Practitioner - Allergy/Immunology 1153406319 Reassigns benefits to 1 organization
I20100913000388 PA Practitioner - Allergy/Immunology 1153406319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Perelman School of Med at the University of Pennsylvania, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergic Disease Associates PCGroup PAC ID 5092708297, 4 clinicians

Practice addresses (Care Compare)

205 N Broad St
Suite 300
Philadelphia, PA 19107-1553
Phone (215) 569-1111

2059 Briggs Rd
Suite 306
Mount Laurel, NJ 08054-4640
Phone (856) 316-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03788500NJMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allergic Disease Associates PC Allergy & Immunology CurrentSince May 14, 1984 Accepting new patients

Locations

2059 Briggs Rd
Ste 306
Mount Laurel, NJ 08054
Phone (856) 316-0300

404 Middletown Blvd
Ste 305
Langhorne, PA 19047
Phone (215) 750-7040

205 N Broad St
Ste 300
Philadelphia, PA 19107
Phone (215) 569-1111

2137 Welsh Rd
Ste 2B
Philadelphia, PA 19115
Phone (215) 667-4433

205 N Broad St
Philadelphia, PA 19107
Phone (215) 496-9300

Organizations & group practices 1

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 7

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1093863334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-569-1111",
            "fax_number": "215-569-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-569-1111",
            "fax_number": "215-569-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MARC",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD023998E",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA03788500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.