Active NPI
Mark Goldgeier, MD
- Dermatology Physician
- Rochester, NY
National Provider Identifier
1629009352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 148706
- Practice address
- 919 Westfall Rd
BLDG a. Suite 200
Rochester, NY 14618-2638 - Phone
- (585) 244-4240
- Fax
- (585) 442-4767
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 148706 | NY | Primary |
Addresses
Primary practice location
919 Westfall Rd
BLDG a. Suite 200
Rochester, NY 14618-2638
Mailing address
919 Westfall Rd
BLDG a. Suite 200
Rochester, NY 14618-2638
Phone (585) 244-4240
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010148706 | Other | NY | EXCELLUS HMO |
| AA0971 | Other | NY | RAILROAD MEDICARE PIN |
| 1016 | Other | NY | EXCELLUS BLUE SHIELD |
| MD4F31 | Other | NY | PREFERRED CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148706 | NY | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1629009352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 WESTFALL RD",
"address_2": "BLDG A. SUITE 200",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146182638",
"telephone_number": "585-244-4240",
"fax_number": "585-442-4767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 WESTFALL RD",
"address_2": "BLDG A. SUITE 200",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146182638",
"telephone_number": "585-244-4240",
"fax_number": "585-442-4767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDGEIER",
"first_name": "MARK",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "148706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS HMO",
"identifier": "010148706",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PIN",
"identifier": "AA0971",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS BLUE SHIELD",
"identifier": "1016",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "MD4F31",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.