Active NPI
Samuel I Goldstein, MD
- Cardiovascular Disease Physician
- Park Ridge, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036086400
- Practice address
- 1875 Dempster St
Suite 555
Park Ridge, IL 60068-1186 - Phone
- (847) 698-5500
- Fax
- (847) 698-0226
- NPI assigned
- Jul 27, 2006
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036086400 | IL | Primary |
Addresses
Primary practice location
1875 Dempster St
Suite 555
Park Ridge, IL 60068-1186
Mailing address
1875 Dempster St
Suite 555
Park Ridge, IL 60068-1186
Phone (847) 698-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036086400 | Medicaid | IL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sgoldstein206058@direct.myadvocateaurora.org | Direct | |
| FHIR URL | sgoldstein206058@direct.myadvocateaurora.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Albert Einstein College of Medicine of Yeshiva University, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160
Hospital & facility affiliations
- Advocate Lutheran General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036086400 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran General Hospital | Cardiovascular Disease | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
1875 W Dempster St
Ste 555
Park Ridge, IL 60068
Phone (847) 698-5500
1875 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-8640
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Cardiovascular Disease Physician
- Park Ridge, IL
- NPI 1801809306
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1609890979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1875 DEMPSTER ST",
"address_2": "SUITE 555",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681186",
"telephone_number": "847-698-5500",
"fax_number": "847-698-0226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1875 DEMPSTER ST",
"address_2": "SUITE 555",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681186",
"telephone_number": "847-698-5500",
"fax_number": "847-698-0226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "SAMUEL",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2021-12-20",
"certification_date": "2021-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036086400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036086400",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sgoldstein206058@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1875 Dempster St",
"address_2": "SUITE 555",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681186",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "sgoldstein206058@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "1875 Dempster St",
"address_2": "SUITE 555",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681186",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.