Jeremy Goldman, O.D., LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA1949 Issued in MD

Legal business name

JEREMY GOLDMAN, O.D., LLC

Practice address

12621 Waterspout CT
Owings Mills, MD 21117-1028

Phone

(443) 621-0756

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Jeremy Goldman, O.D.NPI 1518923556

Title

President

Phone

(443) 621-0756

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy P Goldman, O.D.

  • Optometrist
  • Owings Mills, MD
  • NPI 1518923556

  DC

  Medicare reassignment NPD Authorized official
• Ahava Oppenheimer, O.D.

  • Optometrist
  • Delray Beach, FL
  • NPI 1689697021
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1235221029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12621 WATERSPOUT CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12621 WATERSPOUT CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171028",
            "telephone_number": "443-621-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY GOLDMAN, O.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-621-0756",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DO4272",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DN0639",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.