Individual provider Active NPI

Max Austin Goldstein, M.D.

  • Emergency Medicine Physician
  • Willimantic, CT
National Provider Identifier
1578754164
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
049920 Issued in CT
Practice address
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone
(860) 456-6715
NPI assigned
Aug 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 049920 CT Primary

Addresses

Primary practice location

112 Mansfield Ave
Willimantic, CT 06226-2045

Mailing address

10 Ridgemont Dr
West Hartford, CT 06117-1025
Phone (917) 562-6534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20110629000188 CT Practitioner - Emergency Medicine 8729266440 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nems PLLCGroup PAC ID 2466792833, 37 clinicians
Northeast Emergency Medicine Specialists LLCGroup PAC ID 8729157797, 34 clinicians

Practice addresses (Care Compare)

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

81 Meriden Ave
Southington, CT 06489-3268
Phone (860) 276-8326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.05 of 100Reported as group
Quality
84.92
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as group
Quality
83.66
Promoting interoperability
100
Improvement activities
40
Cost
66.78

Merit-based Incentive Payment System (MIPS)

Final score
84.01 of 100Reported as group
Quality
71.79
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
049920CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 1, 2020 Accepting new patients
Nes Medical Services of Northern Connecticut, P.C. Emergency Medicine Current Accepting new patients
Nes Medical Services of Northern Connecticut, P.C. Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Jan 1, 2017 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 1, 2020 Accepting new patients
Nems PLLC Emergency Medicine CurrentSince Mar 14, 2019 Accepting new patients
Northeast Emergency Medicine Specialists, LLC Emergency Medicine CurrentSince Nov 29, 2014 Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: max.goldstein@xdr.hhchealthdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1578754164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RIDGEMONT DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171025",
            "telephone_number": "917-562-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262045",
            "telephone_number": "860-456-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MAX",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "049920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.