Active NPI
Ira Neustadt, M.D.
- Neurology Physician
- Goshen, NY
National Provider Identifier
1356400725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 146654
- Practice address
- 30 Matthews St
Ste 105
Goshen, NY 10924-1985 - Phone
- (845) 294-5189
- Fax
- (845) 294-9770
- NPI assigned
- Dec 8, 2006
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 146654 | NY | Primary |
Addresses
Primary practice location
30 Matthews St
Ste 105
Goshen, NY 10924-1985
Mailing address
30 Matthews St
Ste 105
Goshen, NY 10924-1985
Phone (845) 294-5189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00617083 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111220000072 | NY | Practitioner - Neurology | 2062687155 | Practice locations: Goshen, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Baylor College of Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
30 Matthews St
Suite 105
Goshen, NY 10924-1985
Phone (845) 294-5189
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146654 | NY | MD | Neurology Physician |
Interoperability endpoints
- iraneustadt@126339.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495152000000",
"number": "1356400725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 MATTHEWS ST",
"address_2": "STE 105",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109241985",
"telephone_number": "845-294-5189",
"fax_number": "845-294-9770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 MATTHEWS ST",
"address_2": "STE 105",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109241985",
"telephone_number": "845-294-5189",
"fax_number": "845-294-9770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUSTADT",
"first_name": "IRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2017-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "146654",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00617083",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; 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.
- 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.