Individual provider Active NPI

Jeffrey Goldberg, OD

  • Corneal and Contact Management Optometrist
  • Plainsboro, NJ
National Provider Identifier
1407827199
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
00095 Issued in NJ
Practice address
666 Plainsboro Rd
Ste 1330
Plainsboro, NJ 08536
Phone
(609) 799-3303
Fax
(609) 799-9619
NPI assigned
Jan 30, 2006
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4774 NJ
Corneal and Contact Management Optometrist 152WC0802X 00095 NJ Primary

Addresses

Primary practice location

666 Plainsboro Rd
Ste 1330
Plainsboro, NJ 08536

Mailing address

666 Plainsboro Rd
Ste 1330
Plainsboro, NJ 08536
Phone (609) 799-3303

Other identifiers 1

IdentifierTypeStateIssuer
2142902MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802000249 NJ Practitioner - Optometry 9234167149 Practice locations: Plainsboro, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

666 Plainsboro Rd
Plainsboro, NJ 08536-3047
Phone (609) 799-3303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4774NJMDOptometrist
00095NJMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1407827199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 PLAINSBORO RD",
            "address_2": "STE 1330",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "08536",
            "telephone_number": "609-799-3303",
            "fax_number": "609-799-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 PLAINSBORO RD",
            "address_2": "STE 1330",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "08536",
            "telephone_number": "609-799-3303",
            "fax_number": "609-799-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4774",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "00095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2142902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainsboro, NJ

Sources for this page

Verify at the official NPI Registry.