Active NPI
Jonathan Howard Goldman, MD
- Cardiovascular Disease Physician
- Mill Valley, CA
National Provider Identifier
1366550428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 016689
- Practice address
- 220 Sunnycrest Ave
Mill Valley, CA 94941-2690 - Phone
- (650) 743-7290
- Fax
- (650) 745-0874
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 016689 | ME | Primary |
Addresses
Primary practice location
220 Sunnycrest Ave
Mill Valley, CA 94941-2690
Mailing address
220 Sunnycrest Ave
Mill Valley, CA 94941-2690
Phone (650) 743-7290
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016689 | ME | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366550428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 SUNNYCREST AVE",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949412690",
"telephone_number": "650-743-7290",
"fax_number": "650-745-0874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 SUNNYCREST AVE",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949412690",
"telephone_number": "650-743-7290",
"fax_number": "650-745-0874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "JONATHAN",
"middle_name": "HOWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ME",
"license": "016689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.