NPIMap

Individual provider Active NPI

Jeffrey Seth Goldstein, M.D., D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Robbinsdale, MN
National Provider Identifier
1104205806
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
77899 Issued in MN
Practice address
3366 Oakdale Ave N Ste 200
Robbinsdale, MN 55422-2962
Phone
(763) 581-5360
NPI assigned
May 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 77899 MN Primary

Addresses

Primary practice location

3366 Oakdale Ave N Ste 200
Robbinsdale, MN 55422-2962

Mailing address

3366 Oakdale Ave N Ste 200
Robbinsdale, MN 55422-2962
Phone (763) 581-5360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201013002169 PA Practitioner - Oral Surgery 7911292230 Reassigns benefits to 1 organization
I20230317001916 CA Practitioner - Maxillofacial Surgery 7911292230 Reassigns benefits to 1 organization
I20240827001145 MN Practitioner - Maxillofacial Surgery 7911292230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-4897

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77899MNMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince Aug 15, 2024 Accepting new patients
Geisinger Clinic CurrentSince Nov 16, 2020 Accepting new patients
North Memorial Health Care Current Accepting new patients
North Memorial Health Care CurrentSince Aug 15, 2024 Accepting new patients
Head and Neck Associates of Central California Oral and Maxillofacial Surgery CurrentSince Dec 13, 2022 Accepting new patients
Geisinger Clinic Oral and Maxillofacial Surgery CurrentSince Nov 16, 2020 Accepting new patients
Geisinger Clinic Current Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

215 N Fresno St
Ste 490
Fresno, CA 93701
Phone (559) 459-4101

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

3366 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5281

3366 Oakdale Ave N
Ste 200
Robbinsdale, MN 55422
Phone (763) 287-5000

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • Direct secure messaging: jgoldstein127879@direct.geisinger.edu

Organizations & group practices 8

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 4

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1104205806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 200",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222962",
            "telephone_number": "763-581-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 200",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222962",
            "telephone_number": "763-581-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JEFFREY",
        "middle_name": "SETH",
        "credential": "M.D., D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MN",
            "license": "77899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.