NPIMap

Individual provider Active NPI

Jared Goldstein, MPT

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1184778474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19690 Issued in MD
Practice address
7080 Deepage Dr
Columbia, MD 21045-5219
Phone
(410) 381-7000
NPI assigned
Jan 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 19690 MD Primary

Addresses

Primary practice location

7080 Deepage Dr
Columbia, MD 21045-5219

Mailing address

7080 Deepage Dr
Columbia, MD 21208

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Health PT Physical Therapist CurrentSince Mar 7, 2021 Accepting new patients
Cutting Edge Physical Therapy CurrentSince Mar 12, 2023 Accepting new patients
Accelerated Physical Therapy Physical Therapist PastSince Sep 25, 2010 Accepting new patients

Locations

9505 Berger Rd
Ste 200
Columbia, MD 21046
Phone (443) 956-8608

Organizations & group practices 9

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184778474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7080 DEEPAGE DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DEEPAGE DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455219",
            "telephone_number": "410-381-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JARED",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.