Individual provider Active NPI

Matthew L Goodstein, M.D.

  • Otolaryngology Physician
  • Glenwood Springs, CO
National Provider Identifier
1376692533
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
31599 Issued in CO
Practice address
1830 Blake Ave
Suite 201
Glenwood Springs, CO 81601-4275
Phone
(970) 945-1112
Fax
(970) 945-4868
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 31599 CO Primary

Addresses

Primary practice location

1830 Blake Ave
Suite 201
Glenwood Springs, CO 81601-4275

Mailing address

1830 Blake Ave
Suite 201
Glenwood Springs, CO 81601-4275
Phone (970) 945-1112

Other identifiers 2

IdentifierTypeStateIssuer
01315993MedicaidCO
1871787168OtherCOMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927000193 CO Practitioner - Otolaryngology 9335173582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Johns Hopkins University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1830 Blake Ave
Glenwood Springs, CO 81601-4261
Phone (970) 945-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31599COMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley View Hospital Association Current Accepting new patients
Matthew L Goodstein MDPC Otolaryngology CurrentSince Mar 9, 2013 Accepting new patients

Locations

1830 Blake Ave
Ste 201
Glenwood Springs, CO 81601
Phone (970) 945-1112

Interoperability endpoints

  • Direct secure messaging: vvh_him@direct.vvh.org

Organizations & group practices 2

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1376692533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "address_2": "SUITE 201",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014275",
            "telephone_number": "970-945-1112",
            "fax_number": "970-945-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "address_2": "SUITE 201",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014275",
            "telephone_number": "970-945-1112",
            "fax_number": "970-945-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSTEIN",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "31599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01315993",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1871787168",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

Verify at the official NPI Registry.