Jordan Goetz, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

031252 Issued in CT

Practice address

60 Church St
Yalesville, CT 06492

Phone

(203) 284-9099

Fax

(203) 284-8107

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Back to Health of Branford, LLC

  • Internal Medicine Physician
  • Branford, CT
  • NPI 1215958772
  NPD (past)
• Hartford Healthcare Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Farmington, CT
  • NPI 1720140221
  NPD (past)
• Midstate Medical Group, PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Meriden, CT
  • NPI 1356361315
  NPD (past)
• Midstate Medical Group, PC

  • Internal Medicine Physician
  • Southington, CT
  • NPI 1427089598
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1104893171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CHURCH ST",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-9099",
            "fax_number": "203-284-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CHURCH ST",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-9099",
            "fax_number": "203-284-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZ",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "031252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Min Deng, D.M.D.
• Michelle Esposito, M.ED., LPC
• David Leon Fried, DMD
• Paul T Gambardella, DPM
• David G Glazer, D.M.D.
• Sandra Gonsalves, LCSW
• Hamden Eye Associates, P.C
• Helen Mrotek LPC, LLC
• Daniel Gabriel Herrera Jr., MS,LPCA
• Rachel Hottin

• Internal Medicine Physician in Yalesville, CT
• Providers in Yalesville, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.