Active NPI
David Lee Goldbloom, M.D.
- Psychiatry Physician
- Wayne, NJ
National Provider Identifier
1487810081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA08857600
- Practice address
- 450 Hamburg Tpke
Suite 2F
Wayne, NJ 07470-8480 - Phone
- (973) 617-6352
- Fax
- (917) 677-5012
- NPI assigned
- Aug 3, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA08857600 | NJ | Primary |
Addresses
Primary practice location
450 Hamburg Tpke
Suite 2F
Wayne, NJ 07470-8480
Mailing address
450 Hamburg Tpke
Suite 2F
Wayne, NJ 07470-8480
Phone (973) 617-6352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA08857600 | NJ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beth Israel Medical Center | Past | Accepting new patients | |
| Beth Israel Medical Center Psychiatry & Behavioral Science | Past | Accepting new patients |
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.
-
- Cognitive & Behavioral Psychologist
- New York, NY
- NPI 1275624199
-
- Cognitive & Behavioral Psychologist
- New York, NY
- NPI 1477582476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453939200000",
"number": "1487810081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 HAMBURG TPKE",
"address_2": "SUITE 2F",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074708480",
"telephone_number": "973-617-6352",
"fax_number": "917-677-5012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 HAMBURG TPKE",
"address_2": "SUITE 2F",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074708480",
"telephone_number": "973-617-6352",
"fax_number": "917-677-5012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBLOOM",
"first_name": "DAVID",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-03",
"last_updated": "2016-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA08857600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.