Organization Active NPI

Ronald Goldstein OD PC

  • Optometrist
  • New York, NY
National Provider Identifier
1366965154
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004856-1 Issued in NY
Legal business name
RONALD GOLDSTEIN OD PC
Practice address
243 E 77TH St Ste 1a
New York, NY 10075-2132
Phone
(212) 249-0002
Fax
(212) 249-5248
NPI assigned
Jul 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Authorized official

Name
Daniela Cabral
Title
Manager
Phone
(212) 249-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV004856-1 NY Primary

Addresses

Primary practice location

243 E 77TH St Ste 1a
New York, NY 10075-2132

Mailing address

243 E 77TH St Ste 1a
New York, NY 10075-2132
Phone (212) 249-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180406001928 NY Part B Supplier - Clinic/Group Practice 3072876945 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

243 E 77th St
Ste 1A
New York, NY 10075
Phone (212) 249-0002

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751500800000",
    "number": "1366965154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 E 77TH ST STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100752132",
            "telephone_number": "212-249-0002",
            "fax_number": "212-249-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 E 77TH ST STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100752132",
            "telephone_number": "212-249-0002",
            "fax_number": "212-249-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD GOLDSTEIN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "CABRAL",
        "authorized_official_first_name": "DANIELA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "212-249-0002"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004856-1",
            "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 Jul 3, 2025; 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.