Individual provider Active NPI

Molly Goldstein, PA-C

  • Surgical Physician Assistant
  • Aventura, FL
National Provider Identifier
1376015297
Registry record updated Jul 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9114792 Issued in FL
Practice address
21110 Biscayne Blvd Ste 400
Aventura, FL 33180-1252
Phone
(305) 918-7050
NPI assigned
Dec 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 841033516 CO
Surgical Physician Assistant 363AS0400X PA.0005583 CO
Surgical Physician Assistant 363AS0400X 9114792 FL Primary

Addresses

Primary practice location

21110 Biscayne Blvd Ste 400
Aventura, FL 33180-1252

Mailing address

21110 Biscayne Blvd Ste 400
Aventura, FL 33180-1252
Phone (305) 918-7050

Other identifiers 1

IdentifierTypeStateIssuer
9000168976MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190206000442 CO Practitioner - Physician Assistant 6204174881
I20220214002414 FL Practitioner - Physician Assistant 6204174881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawnwood Healthcare Specialists LLCGroup PAC ID 4789750118, 47 clinicians

Practice addresses (Care Compare)

11750 Bird Rd
Miami, FL 33175-3530
Phone (305) 559-1334

11750 SW 40 St
Miami, FL 33175-3530
Phone (305) 223-3000

21097 NE 27TH CT
Suite 540
Aventura, FL 33180-1235
Phone (305) 918-7050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9114792FLMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: molly.goldstein@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688860800000",
    "number": "1376015297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD STE 400",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801252",
            "telephone_number": "305-918-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD STE 400",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801252",
            "telephone_number": "305-918-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2023-07-09",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CO",
            "license": "841033516",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0005583",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9114792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000168976",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.