Individual provider Active NPI

Michael Paul Goldman, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • New Haven, CT
National Provider Identifier
1649597279
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
56197 Issued in CT
Practice address
20 York Street
Yale Pediatric Emergency Medicine
New Haven, CT 06511
Phone
(203) 393-8538
NPI assigned
Apr 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 56197 CT Primary
Pediatrics Physician 208000000X 56197 CT

Addresses

Primary practice location

20 York Street
Yale Pediatric Emergency Medicine
New Haven, CT 06511

Mailing address

100 York Street
Pediatric Emergency Medicine
New Haven, CT 06511
Phone (203) 393-8538

Other practice location 1

5 Perryridge Road
Greenwich Hospital
Greenwich, CT 06830
Phone (203) 863-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170530002278 CT Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8123319001 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56197CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
Greenwich Hospital CurrentSince Jul 26, 2017 Accepting new patients
Greenwich Hospital CurrentSince Jul 26, 2017 Accepting new patients
Yale University CurrentSince Jul 1, 2017 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

1 Park St
North Haven, CT 06504
Phone (203) 785-4643

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

Interoperability endpoints

  • Direct secure messaging: mgoldman369739@direct.ynhh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649597279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 YORK STREET",
            "address_2": "PEDIATRIC EMERGENCY MEDICINE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-393-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET",
            "address_2": "YALE PEDIATRIC EMERGENCY MEDICINE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-393-8538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Perryridge Road",
            "address_2": "Greenwich Hospital",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "06830",
            "country_code": "US",
            "telephone_number": "203-863-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CT",
            "license": "56197",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "56197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.