Active NPI
Gerald Bruce Goldstein, M.D.
- Allergy & Immunology Physician
- Tucson, AZ
National Provider Identifier
1104920123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 7108
- Practice address
- 2320 N Wyatt Dr
Suite 71
Tucson, AZ 85712-2151 - Phone
- (520) 318-1860
- Fax
- (520) 318-1859
- NPI assigned
- Sep 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 7108 | AZ | Primary |
Addresses
Primary practice location
2320 N Wyatt Dr
Suite 71
Tucson, AZ 85712-2151
Mailing address
2320 N Wyatt Dr
Suite 71
Tucson, AZ 85712-2151
Phone (520) 318-1860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203175 | Medicaid | AZ |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7108 | AZ | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allergy Asthma Associates PC | Allergy & Immunology | Past | Accepting new patients |
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.
-
- Allergy & Immunology Physician
- Casa Grande, AZ
- NPI 1356442289
Allergy & Immunology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1104920123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2320 N WYATT DR",
"address_2": "SUITE 71",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122151",
"telephone_number": "520-318-1860",
"fax_number": "520-318-1859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2320 N WYATT DR",
"address_2": "SUITE 71",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122151",
"telephone_number": "520-318-1860",
"fax_number": "520-318-1859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "GERALD",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-11",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "AZ",
"license": "7108",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203175",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.