Active NPI
Robert Alan Goldman, MD
- Internal Medicine Physician
- New York, NY
National Provider Identifier
1104866177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 120616
- Practice address
- 227 Madison St
Governeur Health Care Services
New York, NY 10002 - Phone
- (212) 238-7412
- Fax
- (212) 238-7492
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 120616 | NY | Primary |
Addresses
Primary practice location
227 Madison St
Governeur Health Care Services
New York, NY 10002
Mailing address
227 Madison St
Governeur Health Care Services,Dept. Medicine 4TH Floor
New York, NY 10002-7537
Phone (212) 238-7412
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
| License | State | Type | Specialty |
|---|---|---|---|
| 120616 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279584000000",
"number": "1104866177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 MADISON ST",
"address_2": "GOVERNEUR HEALTH CARE SERVICES,DEPT. MEDICINE 4TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100027537",
"telephone_number": "212-238-7412",
"fax_number": "212-238-7492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 MADISON ST",
"address_2": "GOVERNEUR HEALTH CARE SERVICES",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10002",
"telephone_number": "212-238-7412",
"fax_number": "212-238-7492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "ROBERT",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2010-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "120616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.