Individual provider Active NPI

Karli Provost Goldstein, D.O.

  • Gynecology Physician
  • Greenwich, CT
National Provider Identifier
1164765038
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
286616 Issued in NY
Practice address
779 North St
Greenwich, CT 06831-3105
Phone
(646) 844-9602
Fax
(646) 846-2310
NPI assigned
Mar 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 286616 NY Primary

Addresses

Primary practice location

779 North St
Greenwich, CT 06831-3105

Mailing address

204 Corlies Ave
Pelham, NY 10803-1904
Phone (832) 577-3773

Other practice location 1

4650 Lincoln Blvd
Marina Del Rey, CA 90292-6306
Phone (310) 823-8911

Other practice location 2

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-3277

Other practice location 3

450 N Roxbury Dr Ste 240
Beverly Hills, CA 90210-4240
Phone (310) 651-2040

Other practice location 4

4 Westchester Park Dr Ste 400
White Plains, NY 10604-3497
Phone (646) 844-9602

Other practice location 5

535 5th Ave
New York, NY 10017-3620
Phone (646) 844-9602

Other practice location 6

100 E 77th St
New York, NY 10075-1850
Phone (212) 434-2000

Other practice location 7

204 Corlies Ave
Pelham, NY 10803-1904
Phone (832) 577-3773

Other practice location 8

701 N Broadway
Sleepy Hollow, NY 10591-1020
Phone (914) 366-3000

Other practice location 9

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 894-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
286616NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Reproductive Surgery LLC Gynecology CurrentSince Jun 1, 2023 Accepting new patients
Esse Integrated Reproductive Wellness PLLC Current Accepting new patients
Esse Integrated Reproductive Surgery PLLC CurrentSince Apr 27, 2025 Accepting new patients

Locations

4 Westchester Park Dr
Ste 400
White Plains, NY 10604
Phone (646) 844-9602

Interoperability endpoints

  • Direct secure messaging: kgoldstein65788@northwell.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1164765038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CORLIES AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108031904",
            "telephone_number": "832-577-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 NORTH ST",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313105",
            "telephone_number": "646-844-9602",
            "fax_number": "646-846-2310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 Lincoln Blvd",
            "address_purpose": "LOCATION",
            "city": "Marina Del Rey",
            "state": "CA",
            "postal_code": "902926306",
            "country_code": "US",
            "telephone_number": "310-823-8911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8700 Beverly Blvd",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-3277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 N Roxbury Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902104240",
            "country_code": "US",
            "telephone_number": "310-651-2040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Westchester Park Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106043497",
            "country_code": "US",
            "telephone_number": "646-844-9602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100173620",
            "country_code": "US",
            "telephone_number": "646-844-9602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E 77th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751850",
            "country_code": "US",
            "telephone_number": "212-434-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Corlies Ave",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "NY",
            "postal_code": "108031904",
            "country_code": "US",
            "telephone_number": "832-577-3773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Sleepy Hollow",
            "state": "NY",
            "postal_code": "105911020",
            "country_code": "US",
            "telephone_number": "914-366-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Engle St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076311808",
            "country_code": "US",
            "telephone_number": "201-894-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "KARLI",
        "middle_name": "PROVOST",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-29",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "286616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.