Individual provider Active NPI

Robert Goldberg, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1235297037
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003814 Issued in NY
Practice address
425 Lexington Ave
Eastside Optometric, P.C. Co Lenscrafters
New York, NY 10017-3903
Phone
(212) 986-9281
Fax
(212) 681-6102
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003814 NY Primary

Addresses

Primary practice location

425 Lexington Ave
Eastside Optometric, P.C. Co Lenscrafters
New York, NY 10017-3903

Mailing address

425 Lexington Ave
Eastside Optometric, P.C. Co Lenscrafters
New York, NY 10017-3903
Phone (212) 986-9281

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

State licenses

LicenseStateTypeSpecialty
TUV003814NYMDOptometrist
003814NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1235297037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LEXINGTON AVE",
            "address_2": "EASTSIDE OPTOMETRIC, P.C. CO LENSCRAFTERS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173903",
            "telephone_number": "212-986-9281",
            "fax_number": "212-681-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 LEXINGTON AVE",
            "address_2": "EASTSIDE OPTOMETRIC, P.C. CO LENSCRAFTERS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173903",
            "telephone_number": "212-986-9281",
            "fax_number": "212-681-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.