Individual provider Active NPI

Carly Nicole Goldstein, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1629667282
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
530 1St Ave
New York, NY 10016-6402
Phone
(212) 263-3166
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

530 1St Ave
New York, NY 10016-6402

Mailing address

23 Fairview Rd
Marlboro, NJ 07746-1369
Phone (732) 757-8890

Other practice location 1

23 Fairview Rd
Marlboro, NJ 07746-1369
Phone (732) 757-8890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgoldstein436413@nyumc.direct-ci.com

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210429002105 NY Practitioner - Physician Assistant 4789093949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 12, 2021 Accepting new patients
New York University CurrentSince Apr 12, 2021 Accepting new patients

Locations

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: cgoldstein436413@nyumc.direct-ci.com

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.

Hospital & facility affiliations 7

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": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1629667282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FAIRVIEW RD",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461369",
            "telephone_number": "732-757-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Fairview Rd",
            "address_purpose": "LOCATION",
            "city": "Marlboro",
            "state": "NJ",
            "postal_code": "077461369",
            "country_code": "US",
            "telephone_number": "732-757-8890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "CARLY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgoldstein436413@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.