Individual provider Active NPI

Boris Goldman, M.D.

  • Specialist
  • Westport, CT
National Provider Identifier
1104821560
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
034822 Issued in CT
Practice address
32 Imperial Ave FL 2
Westport, CT 06880-4328
Phone
(203) 222-3700
Fax
(203) 222-3703
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 034822 CT Primary

Addresses

Primary practice location

32 Imperial Ave FL 2
Westport, CT 06880-4328

Mailing address

32 Imperial Ave
2ND Floor
Westport, CT 06880-4328
Phone (203) 222-3700

Other identifiers 1

IdentifierTypeStateIssuer
001348227MedicaidCT

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034822CTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Audiology & Hearing Aid Services Past Accepting new patients
Westport Cardiology,LLC Specialist PastSince Jan 1, 2007 Accepting new patients

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1104821560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 IMPERIAL AVE",
            "address_2": "2ND FLOOR",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804328",
            "telephone_number": "203-222-3700",
            "fax_number": "203-222-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 IMPERIAL AVE FL 2",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804328",
            "telephone_number": "203-222-3700",
            "fax_number": "203-222-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "034822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001348227",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.