Individual provider Active NPI

Keith Goldstein, D.P.M.

  • Podiatrist
  • Orlando, FL
National Provider Identifier
1639235765
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO2436 Issued in FL
Practice address
4649 Gardens Park Blvd Apt 3308
Orlando, FL 32839-2623
Phone
(407) 509-8852
NPI assigned
Jan 1, 2007
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO2436 FL Primary

Addresses

Primary practice location

4649 Gardens Park Blvd Apt 3308
Orlando, FL 32839-2623

Mailing address

4649 Gardens Park Blvd Apt 3308
Orlando, FL 32839-2623
Phone (407) 509-8852

Other identifiers 2

IdentifierTypeStateIssuer
2701686OtherFLEVERCARE
340109000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101111001330 FL Practitioner - Podiatry 2860607868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1317 Edgewater Dr
Orlando, FL 32804-6350
Phone (407) 509-8852

415 E Pine St
Suite 1513
Orlando, FL 32801-6626

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue29
Removal of skin lesions64
Removal of nail tissue1517
Removal or shaving of skin growth873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keith R Goldstein D P M P a Podiatrist CurrentSince Oct 7, 2010 Accepting new patients

Locations

1317 Edgewater Dr
Orlando, FL 32804
Phone (877) 436-8527

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1639235765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4649 GARDENS PARK BLVD APT 3308",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328392623",
            "telephone_number": "407-509-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4649 GARDENS PARK BLVD APT 3308",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328392623",
            "telephone_number": "407-509-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "2701686",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340109000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.