Individual provider Active NPI

Timothy J Goldsmith, OD

  • Optometrist
  • New Prague, MN
National Provider Identifier
1114912573
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2401 Issued in MN
Practice address
1101 1St St NE
New Prague, MN 56071-2197
Phone
(952) 758-2080
Fax
(952) 758-5922
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 2401 MN
Optometrist 152W00000X 2401 MN Primary

Addresses

Primary practice location

1101 1St St NE
New Prague, MN 56071-2197

Mailing address

PO Box 261
New Prague, MN 56071-0261
Phone (952) 758-2080

Other identifiers 1

IdentifierTypeStateIssuer
951825800MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Tim.Goldsmith@direct.revolutionehr.com Health Information Exchange (HIE) Goldsmith Eye Care PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000863 MN Practitioner - Optometry 8022149814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goldsmith Eye Care PCGroup PAC ID 3173753670, 6 clinicians

Practice addresses (Care Compare)

1101 1St St NE
New Prague, MN 56071-2197
Phone (952) 758-2080

Merit-based Incentive Payment System (MIPS)

Final score
92.2 of 100Reported as group
Quality
84.41
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsmith Eye Care PC Optometrist CurrentSince Sep 12, 2012 Accepting new patients

Locations

112 Main St E
New Prague, MN 56071
Phone (952) 758-2080

1101 1st St NE
New Prague, MN 56071
Phone (952) 226-1400

15875 Franklin Trl SE
Ste 111
Prior Lake, MN 55372

Interoperability endpoints

  • Direct secure messaging: tim.goldsmith@direct.revolutionehr.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1114912573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560710261",
            "telephone_number": "952-758-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 1ST ST NE",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560712197",
            "telephone_number": "952-758-2080",
            "fax_number": "952-758-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "2401",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951825800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tim.Goldsmith@direct.revolutionehr.com",
            "affiliation": "Y",
            "affiliationName": "Goldsmith Eye Care PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1101 1st St NE",
            "city": "New Prague",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560712197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Prague, MN

Sources for this page

Verify at the official NPI Registry.