Jack Goldstein, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA03701800 Issued in NJ

Practice address

218C Sunset Rd
Willingboro, NJ 08046-1104

Phone

(609) 877-0400

Fax

(609) 877-1682

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Gastroenterology

Education

Hahnemann University College of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Department of Medicine Group PAGroup PAC ID 2163335878, 474 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score

91.83 of 100Reported as group

Quality

88.78

Promoting interoperability

99

Improvement activities

40

Cost

74.17

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgoldstein5477@direct.cooperhealth.edu

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.

• CMC Department of Medicine Group PA

  • Cardiovascular Disease Physician
  • Camden, NJ
  • NPI 1609908094
  Medicare reassignment Care Compare group
• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Cooper Health System

  • Land Ambulance
  • Camden, NJ
  • NPI 1174976724

  Hospital

  Care Compare affiliation
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  Care Compare affiliation

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1114929858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218C SUNSET RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461104",
            "telephone_number": "609-877-0400",
            "fax_number": "609-877-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03701800",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA03701800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1998200",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1018864",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3641368",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALHT/KEYSTONE/ IBC",
            "identifier": "0090492000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3818454",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO/PA BS",
            "identifier": "183070",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERISITY HEALTH PLAN",
            "identifier": "21420",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET, INC",
            "identifier": "3K6075",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1346033",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.