Individual provider Active NPI

Peter Anthony Goulden

  • Endocrinology, Diabetes & Metabolism Physician
  • New York, NY
National Provider Identifier
1457698904
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
298193 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-4000
Fax
(212) 523-7410
NPI assigned
Jan 3, 2013
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X E-7811 AR
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 298193 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8188

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
I20190411001020 NY Practitioner - Endocrinology 7719122167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy Place
New York, NY 10029-6574
Phone (212) 987-3100

440 W 114TH St
New York, NY 10025-1796
Phone (212) 523-8672

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
298193NYMDPsychiatric/Mental Health Registered Nurse
E-7811ARMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Endocrinology, Diabetes & Metabolism CurrentSince Apr 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1457698904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175699",
            "telephone_number": "646-605-8188",
            "fax_number": "212-523-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-4000",
            "fax_number": "212-523-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDEN",
        "first_name": "PETER",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AR",
            "license": "E-7811",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "298193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.