Individual provider Active NPI

Alan Jay Goodman, M.D.

  • Allergy & Immunology Physician
  • New York, NY
National Provider Identifier
1447255351
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
165206 Issued in NY
Practice address
525 E 86TH St Apt 8C
New York, NY 10028-7514
Phone
(973) 283-5864
Fax
(888) 873-3987
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 165206 NY
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 25MA5282400 NJ
Allergy & Immunology Physician 207K00000X 165206 NY Primary
Allergy & Immunology Physician 207K00000X MA52824 NJ

Addresses

Primary practice location

525 E 86TH St Apt 8C
New York, NY 10028-7514

Mailing address

525 E 86TH St Apt 8C
New York, NY 10028-7514
Phone (973) 283-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170317001068 NY Practitioner - Allergy/Immunology 4183754815 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA52824NJMDAllergy & Immunology Physician
25MA5282400NJMDAllergy & Immunology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essen Medical Associates, PC CurrentSince Feb 19, 2021 Accepting new patients
Essen Medical Associates,PC CurrentSince Feb 19, 2021 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince Feb 19, 2021 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Feb 19, 2021 Accepting new patients
Allergy, Asthma & Immunology, PA Allergy & Immunology PastSince Jan 1, 1990 Accepting new patients

Locations

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Organizations & group practices 6

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1447255351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 86TH ST APT 8C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287514",
            "telephone_number": "973-283-5864",
            "fax_number": "888-873-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 86TH ST APT 8C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287514",
            "telephone_number": "973-283-5864",
            "fax_number": "888-873-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ALAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NY",
            "license": "165206",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NJ",
            "license": "25MA5282400",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "165206",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "MA52824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.