John Goodfriend

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

993386984 Issued in NY

Practice address

4 Durr Road
Jeffersonville, NY 12748

Phone

(845) 428-1678

NPI assigned

Aug 21, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dependable Medical Transsport

  • Non-emergency Medical Transport (VAN)
  • Jeffersonville, NY
  • NPI 1437614112
  Authorized official Same address or phone

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1548786676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678",
            "city": "JEFFERSONVILLE",
            "state": "NY",
            "postal_code": "127480678",
            "telephone_number": "845-428-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DURR ROAD",
            "city": "JEFFERSONVILLE",
            "state": "NY",
            "postal_code": "12748",
            "telephone_number": "845-428-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFRIEND",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "993386984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04564518",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Busardo-Bolduc, INTERN THERAPIST
• Ander Camino
• Dependable Medical Transsport
• Eyes on Main St. Optometry PLLC
• Joseph A Fiorille, R.PH
• Nicole Hillard, RN
• Jefferson Pharmacy Inc
• Jeffersonville Volunteer First Aid Corps Inc
• JJJ Yaut, LLC (Jeff Senior Living)
• Eileen Anne Krom, M.S. CCC-SLP

• Non-emergency Medical Transport (VAN) in Jeffersonville, NY
• Providers in Jeffersonville, NY by specialty
• Non-emergency Medical Transport (VAN) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.