Organization Active NPI

Leonard S. Goldstein Odpc

  • Optometrist
  • Elmhurst, NY
National Provider Identifier
1376875807
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003454 Issued in NY
Legal business name
LEONARD S. GOLDSTEIN ODPC
Practice address
5910 Junction Blvd
Elmhurst, NY 11373-5156
Phone
(718) 271-6883
Fax
(718) 699-5905
NPI assigned
Feb 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Authorized official

Name
Dr. Leonard Sheldon Goldstein, ODNPI 1508846965
Title
President
Phone
(718) 271-6883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV003454 NY Primary

Addresses

Primary practice location

5910 Junction Blvd
Elmhurst, NY 11373-5156

Mailing address

5910 Junction Blvd
Elmhurst, NY 11373-5156
Phone (718) 271-6883

Other identifiers 1

IdentifierTypeStateIssuer
00684735MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101209000392 NY Part B Supplier - Clinic/Group Practice 4880711456 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

Locations

5910 Junction Blvd
Flushing, NY 11373
Phone (718) 271-6883

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": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1376875807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 JUNCTION BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735156",
            "telephone_number": "718-271-6883",
            "fax_number": "718-699-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 JUNCTION BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735156",
            "telephone_number": "718-271-6883",
            "fax_number": "718-699-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD S. GOLDSTEIN ODPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "SHELDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-271-6883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00684735",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; 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.