Individual provider Active NPI

Nasser Golestaneh, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1659449338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
118735 Issued in NY
Practice address
1199 Ocean Ave
Brooklyn, NY 11230
Phone
(718) 859-7446
Fax
(718) 859-3395
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 118735 NY Primary

Addresses

Primary practice location

1199 Ocean Ave
Brooklyn, NY 11230

Mailing address

5 Roscoe CT
Greenvale, NY 11548
Phone (516) 484-5874

Other identifiers 1

IdentifierTypeStateIssuer
00221696MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
118735NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659449338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ROSCOE CT",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "11548",
            "telephone_number": "516-484-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11230",
            "telephone_number": "718-859-7446",
            "fax_number": "718-859-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLESTANEH",
        "first_name": "NASSER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "118735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00221696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.