Individual provider Active NPI

Raimonda Goldman, D.O.

  • Specialist
  • Teaneck, NJ
National Provider Identifier
1639482581
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MB08766800 Issued in NJ
Practice address
718 Teaneck Road
Regional Cancer Center
Teaneck, NJ 07666-0000
Phone
(201) 227-6008
Fax
(201) 227-6002
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MB08766800 NJ Primary

Addresses

Primary practice location

718 Teaneck Road
Regional Cancer Center
Teaneck, NJ 07666-0000

Mailing address

718 Teaneck Road
Teaneck, NJ 07666-0000
Phone (201) 227-6008

Other identifiers 1

IdentifierTypeStateIssuer
0241032MedicaidNJ

Other names 1

  • Raimonda Kopelnitsky Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110510000047 NJ Practitioner - Hematology/OncologyPractitioner - Medical Oncology 0143406199 Reassigns benefits to 1 organization
I20210316003036 NY Practitioner - Medical Oncology 0143406199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 227-6008

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB08766800NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Feb 12, 2021 Accepting new patients
Excelcare Medical Associates, PA CurrentSince Jun 1, 2012 Accepting new patients
Montefiore Medical Center CurrentSince Feb 12, 2021 Accepting new patients
Hematology Oncology Partners, PC Specialist Past Accepting new patients

Locations

1 W Ridgewood Ave
Ste 203
Paramus, NJ 07652
Phone (201) 312-5243

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

111 E 210th St
Bronx, NY 10467

984 N Broadway
Yonkers, NY 10701
Phone (914) 751-5432

Organizations & group practices 4

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 2

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": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1639482581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 TEANECK ROAD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076660000",
            "telephone_number": "201-227-6008",
            "fax_number": "201-227-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK ROAD",
            "address_2": "REGIONAL CANCER CENTER",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076660000",
            "telephone_number": "201-227-6008",
            "fax_number": "201-227-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "RAIMONDA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB08766800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0241032",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAIMONDA",
            "last_name": "KOPELNITSKY",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.