Individual provider Active NPI

Joel B. Goldberg, O.D.

  • Optometrist
  • Monsey, NY
National Provider Identifier
1184629719
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT004362-1 Issued in NY
Practice address
2 Cambridge Rd
Monsey, NY 10952-1305
Phone
(845) 362-3538
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT004362-1 NY Primary

Addresses

Primary practice location

2 Cambridge Rd
Monsey, NY 10952-1305

Mailing address

2 Cambridge Rd
Monsey, NY 10952-1305
Phone (845) 362-3538

Other identifiers 1

IdentifierTypeStateIssuer
01123124MedicaidNY

Other names 1

  • Joel B. Goldberg Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091020000303 NY Practitioner - Optometry 5092852350 Reassigns benefits to 1 organization
Practice locations: Monsey, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aizer Health , IncGroup PAC ID 6406747989, 46 clinicians

Practice addresses (Care Compare)

49 Forest Rd
Monroe, NY 10950-2923
Phone (845) 782-3242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT004362-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aizer Health , Inc. CurrentSince Oct 1, 2011 Accepting new patients
Aizer Health , Inc. CurrentSince Oct 1, 2011 Accepting new patients
Primary Eyecare Optometry PC Optometrist PastSince Nov 4, 2004 Accepting new patients

Locations

49 Forest Rd
Monroe, NY 10950
Phone (845) 782-3242

Interoperability endpoints

  • Direct secure messaging: joel.goldberg@echc.eclinicaldirectplus.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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1184629719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAMBRIDGE RD",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521305",
            "telephone_number": "845-362-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAMBRIDGE RD",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521305",
            "telephone_number": "845-362-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JOEL",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT004362-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01123124",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOEL",
            "last_name": "GOLDBERG",
            "middle_name": "B.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Monsey, NY

Sources for this page

Verify at the official NPI Registry.