Individual provider Active NPI

Jonathan Goldfarb, DPT

  • Physical Therapist
  • Guilford, CT
National Provider Identifier
1144875121
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12355 Issued in CT
Practice address
705 Boston Post Rd Ste 5a
Guilford, CT 06437-2733
Phone
(203) 458-1645
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12355 CT Primary

Addresses

Primary practice location

705 Boston Post Rd Ste 5a
Guilford, CT 06437-2733

Mailing address

19 Dune Rd
Asbury Park, NJ 07712-3765
Phone (732) 546-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815001084 CT Practitioner - Physical Therapist in Private Practice 7810224797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Specialists of Guilford, LLCGroup PAC ID 8820263759, 13 clinicians

Practice addresses (Care Compare)

705 Boston Post Rd
Suite 5a
Guilford, CT 06437-2733
Phone (203) 458-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12355CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists Physical Therapist CurrentSince Aug 7, 2019 Accepting new patients
Physical Therapy Specialists PastSince Aug 7, 2019 Accepting new patients

Locations

705 Boston Post Rd
Ste 5A
Guilford, CT 06437
Phone (203) 458-1645

840 Boston Post Rd
#200
Old Saybrook, CT 06475
Phone (203) 458-1645

Organizations & group practices 2

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1144875121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DUNE RD",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077123765",
            "telephone_number": "732-546-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BOSTON POST RD STE 5A",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372733",
            "telephone_number": "203-458-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.