Individual provider Active NPI

Gershon Amihud Goldman, DPM

  • Podiatrist
  • Jackson Heights, NY
National Provider Identifier
1568473726
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N0040951 Issued in NY
Practice address
8710 37TH Ave
Suite D
Jackson Heights, NY 11372-7704
Phone
(718) 457-7443
Fax
(718) 457-6137
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N0040951 NY Primary

Addresses

Primary practice location

8710 37TH Ave
Suite D
Jackson Heights, NY 11372-7704

Mailing address

8710 37TH Ave
Suite D
Jackson Heights, NY 11372-7704
Phone (718) 457-7443

Other identifiers 1

IdentifierTypeStateIssuer
00971077MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000138 NY Practitioner - Podiatry 8729008354 Practice locations: Bronx, NY; Jackson Heights, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8710 37TH Ave
Suite D
Jackson HTS, NY 11372-7748

8710 37TH Ave D
Jackson Heights, NY 11372-7748
Phone (718) 457-7443

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions479
Removal of nail tissue1701
Removal or shaving of skin growth275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N0040951NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Fayn Medical PC PastSince Jun 1, 2006 Accepting new patients
Indira Kairam, MD P.C. Past Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1568473726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 37TH AVE",
            "address_2": "SUITE D",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727704",
            "telephone_number": "718-457-7443",
            "fax_number": "718-457-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 37TH AVE",
            "address_2": "SUITE D",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727704",
            "telephone_number": "718-457-7443",
            "fax_number": "718-457-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "GERSHON",
        "middle_name": "AMIHUD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N0040951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00971077",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.