Individual provider Active NPI

Elan Luria Goldwaser, DO

  • Sports Medicine (Family Medicine) Physician
  • Scarsdale, NY
National Provider Identifier
1215378369
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
289782 Issued in NY
Practice address
693 White Plains Rd
Scarsdale, NY 10709
Phone
(914) 787-3292
Fax
(212) 304-7050
NPI assigned
Jul 17, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X 289782 NY Primary

Addresses

Primary practice location

693 White Plains Rd
Scarsdale, NY 10709

Mailing address

622 W 168TH St PH 11
New York, NY 10032-3720
Phone (212) 305-9137

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address elg9112@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170906003126 NY Practitioner - Sports MedicinePractitioner - Family Practice 7214200682 Reassigns benefits to 2 organizations
I20200901000025 NJ Practitioner - Sports Medicine 7214200682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia Doctors of New Jersey P CGroup PAC ID 3375674138, 58 clinicians
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, shared by 10 NPIs, 2,262 clinicians

Practice addresses (Care Compare)

500 Grand Ave
Suite 1
Englewood, NJ 07631-4968
Phone (212) 342-8586

622 W 168TH St
New York, NY 10032-3720

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Multi-Specialty CurrentSince Jan 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Multi-Specialty CurrentSince Aug 1, 2017 Accepting new patients
Columbia Doctors of New Jersey, P. C. Multi-Specialty CurrentSince Jun 21, 2020 Accepting new patients
Trustees of Columbia University in the City of New York Multi-Specialty CurrentSince Aug 1, 2017 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 21, 2020 Accepting new patients
The Trustees of Columbia University in the City of New York Multi-Specialty Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Multi-Specialty Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

500 Grand Ave
Englewood, NJ 07631
Phone (201) 541-0440

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

1 Pondfield Rd
Ste 1
Bronxville, NY 10708
Phone (212) 305-5976

693 White Plains Rd
Eastchester, NY 10709
Phone (914) 750-4690

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
Ph 111130
New York, NY 10032
Phone (212) 305-0762

622 W 168th St
Ph 11
New York, NY 10032
Phone (212) 305-5976

51 W 51st St
Ste 370
New York, NY 10019
Phone (631) 254-5577

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 7

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 6

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1215378369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST PH 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9137",
            "fax_number": "212-304-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 WHITE PLAINS RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "10709",
            "telephone_number": "914-787-3292",
            "fax_number": "212-304-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDWASER",
        "first_name": "ELAN",
        "middle_name": "LURIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-17",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "289782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "693 White Plains Rd",
            "city": "Scarsdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elg9112@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "693 White Plains Rd",
            "city": "Scarsdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "693 White Plains Rd",
            "city": "Scarsdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.