Jeffrey Stuart Goldblatt, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

016369 Issued in CT

Practice address

4 Huntley Road
Sutie 1
Old Lyme, CT 06371

Phone

(860) 434-4073

Fax

(860) 434-4635

NPI assigned

Jun 23, 2006

Last updated

Sep 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Connecticut Vascular Center, LLC

  dba The Vascular Experts

  • Vascular Surgery Physician
  • Stratford, CT
  • NPI 1033318175
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1366478158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HUNTLEY RD",
            "address_2": "SUITE 1",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711449",
            "telephone_number": "860-434-4073",
            "fax_number": "860-434-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HUNTLEY ROAD",
            "address_2": "SUTIE 1",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "06371",
            "telephone_number": "860-434-4073",
            "fax_number": "860-434-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "JEFFREY",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "016369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristan Filippi
• Brett J.M. Flynn, EMT-P , ATC, CSCS
• Karl R. Friedmann, M.D.
• Frontline Wellness LLC
• Shragit Glazman, MD
• Karl M Goldkamp, ND
• Mark Gombotz
• Jay Allan Graves, M.D.
• Elizabeth Green
• Ruth E Greenblatt, PT

• Surgery Physician in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.