Individual provider Active NPI

Miriam Ann Goldsmith, PA

  • Medical Physician Assistant
  • Englewood, NJ
National Provider Identifier
1164732558
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00209200 Issued in NJ
Practice address
229 Engle St
Englewood, NJ 07631-2409
Phone
(201) 567-8999
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00209200 NJ Primary

Addresses

Primary practice location

229 Engle St
Englewood, NJ 07631-2409

Mailing address

39 W Englewood Ave
Teaneck, NJ 07666-5054
Phone (732) 598-6924

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000327 NJ Practitioner - Physician Assistant 3173703121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rutgers School of Dental Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endocrinology Consultants, PCGroup PAC ID 0840387023, 9 clinicians

Practice addresses (Care Compare)

199 Engle St
Englewood, NJ 07631-2409
Phone (201) 567-8999

221 Engle St
Englewood, NJ 07631-2409
Phone (201) 567-8999

229 Engle St
Englewood, NJ 07631-2409
Phone (201) 567-8999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00209200NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hand Therapy Center, LLC Past Accepting new patients

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1164732558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 W ENGLEWOOD AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076665054",
            "telephone_number": "732-598-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312409",
            "telephone_number": "201-567-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "MIRIAM",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00209200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.