Jenna Nicole Goldstein, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

030293 Issued in NY

Practice address

285 Middle Country Road
#105
Smithtown, NY 11787

Phone

(631) 509-0390

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Massachusetts College of Osteopathy, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Middle Country Endocrinology, PCGroup PAC ID 9032256169, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CJCEAD/Endpoint/CJCEAD

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.

• Middle Country Endocrinology, PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Smithtown, NY
  • NPI 1295068930
  Medicare reassignment Care Compare group

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

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1033224704
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1225507114
  Care Compare affiliation
• University Hospital at Stony Brook

  • Land Ambulance
  • Stony Brook, NY
  • NPI 1306620588

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Greenport, NY
  • NPI 1881690691
  Care Compare affiliation
• University Hospital at Stony Brook

  • Clinic/Center
  • Greenport, NY
  • NPI 1932466604

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  Care Compare affiliation

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701475200000",
    "number": "1134813249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872978",
            "telephone_number": "631-509-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY ROAD",
            "address_2": "#105",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-509-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "030293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gold Coast Podiatry, PC
• Avram Gold, M.D.
• Richard Samuel Gold, MD
• Richard Bruce Goldman, D.D.S.
• Thomas Michael Goldrick, RPA
• Richard Scott Goldstein, MD
• Tracy-Lynn Patricia Goldstein, LMSW, LCSW
• Vanessa Fonseca Gomes, PHD
• Jose Manuel Gomez
• Paula Gonthier, LCSW

• Physician Assistant in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; 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.