Active NPI
Irwin Goldstein, MD
- Urology Physician
- San Diego, CA
National Provider Identifier
1215058441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- G41116
- Practice address
- 5555 Reservoir Drive
Suite 300
San Diego, CA 92120-5270 - Phone
- (619) 987-7432
- Fax
- (619) 501-0717
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | G41116 | CA | Primary |
Addresses
Primary practice location
5555 Reservoir Drive
Suite 300
San Diego, CA 92120-5270
Mailing address
5555 Reservoir Dr
Ste 300
San Diego, CA 92120-5134
Phone (619) 265-8865
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 13, 2014 through Jan 13, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41116 | CA | MD | Pharmacist |
| G41116 | CA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Windber Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372723200000",
"number": "1215058441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR",
"address_2": "STE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205134",
"telephone_number": "619-265-8865",
"fax_number": "619-265-7696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DRIVE",
"address_2": "SUITE 300",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205270",
"telephone_number": "619-987-7432",
"fax_number": "619-501-0717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "IRWIN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2013-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "G41116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.