Individual provider Active NPI

David Victor Goldman, M.S.P.T.

  • Physical Therapist
  • Englewood, NJ
National Provider Identifier
1215950845
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01155800 Issued in NJ
Practice address
20 Nordhoff PL FL 2
The Gym
Englewood, NJ 07631-4811
Phone
(201) 567-9399
Fax
(201) 567-9394
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 020989 NY
Physical Therapist 225100000X 40QA01155800 NJ Primary

Addresses

Primary practice location

20 Nordhoff PL FL 2
The Gym
Englewood, NJ 07631-4811

Mailing address

20 Nordhoff PL FL 2
Thee Gym
Englewood, NJ 07631-4811
Phone (201) 567-9399

Other identifiers 4

IdentifierTypeStateIssuer
2300837OtherUNITED HEALTHCARE -OUT OF NETWORK
6455113OtherNJAETNA HMO -OON
7742471OtherAETNA -OUT OF NETWORK
P4194238OtherOXFORD -OUT OF NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090702000030 NJ Practitioner - Physical Therapist in Private Practice 2264323997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 Nordhoff PL
Englewood, NJ 07631-4811

20 Nordhoff Place
Englewood, NJ 07631-4811
Phone (646) 321-2639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020989NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Goldman Physical Therapy, LLC Physical Therapist CurrentSince Mar 6, 2012 Accepting new patients
Gold Star Physical Therapy LLC Physical Therapist Past Accepting new patients
KLB Physical Therapy, PLLC Physical Therapist Past Accepting new patients

Locations

20 Nordhoff Pl
Fl 2
Englewood, NJ 07631
Phone (201) 567-9399

20 Nordhoff Pl
Englewood, NJ 07631
Phone (201) 595-0404

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1215950845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NORDHOFF PL FL 2",
            "address_2": "THEE GYM",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314811",
            "telephone_number": "201-567-9399",
            "fax_number": "201-567-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NORDHOFF PL FL 2",
            "address_2": "THE GYM",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314811",
            "telephone_number": "201-567-9399",
            "fax_number": "201-567-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "DAVID",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020989",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01155800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE -OUT OF NETWORK",
            "identifier": "2300837",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO -OON",
            "identifier": "6455113",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA -OUT OF NETWORK",
            "identifier": "7742471",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD -OUT OF NETWORK",
            "identifier": "P4194238",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.