NPIMap

Individual provider Active NPI

Kenneth Brian Goldstein, MD.

  • Internal Medicine Physician
  • Mt. Laurel, NJ
National Provider Identifier
1659473239
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05323200 Issued in NJ
Practice address
1000 Birchfield Drive
Suite 1004
Mt. Laurel, NJ 08054
Phone
(856) 866-1557
Fax
(856) 231-7955
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05323200 NJ Primary

Addresses

Primary practice location

1000 Birchfield Drive
Suite 1004
Mt. Laurel, NJ 08054

Mailing address

1000 Birchfield Drive
Suite 1004
Mt. Laurel, NJ 08054
Phone (856) 866-1557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000065 NJ Practitioner - Internal Medicine 3375568363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Laurel Primary Care Physicians, PC 2 clinicians

Practice addresses (Care Compare)

1000 Birchfield Dr
Suite 1004
Mount Laurel, NJ 08054-4019
Phone (856) 866-1557

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Samaritan Healthcare and Hospice Hospice, Mount Laurel, NJ, CCN 311504
  • Serenity Hospice Care Hospice, Trenton, NJ, CCN 311574
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014
  • Aspen Hills Healthcare Center Nursing home, Pemberton, NJ, CCN 315260

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Laurel Primary Care Physicians, PC Internal Medicine CurrentSince Oct 2, 1989 Accepting new patients
Aspen Hills Healthcare Center LLC Past Accepting new patients

Locations

1000 Birchfield Dr
#100
Mount Laurel, NJ 08054
Phone (856) 866-1557

1000 Birchfield Dr
Ste 1004
Mount Laurel, NJ 08054
Phone (856) 866-1557

600 Pemberton Browns Mills Rd
Pemberton, NJ 08068
Phone (609) 726-7000

Interoperability endpoints

  • Direct secure messaging: kenneth.goldstein.1@16054.direct.athenahealth.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 12

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1659473239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BIRCHFIELD DRIVE",
            "address_2": "SUITE 1004",
            "city": "MT. LAUREL",
            "state": "NJ",
            "postal_code": "08054",
            "telephone_number": "856-866-1557",
            "fax_number": "856-231-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BIRCHFIELD DRIVE",
            "address_2": "SUITE 1004",
            "city": "MT. LAUREL",
            "state": "NJ",
            "postal_code": "08054",
            "telephone_number": "856-866-1557",
            "fax_number": "856-231-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "KENNETH",
        "middle_name": "BRIAN",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05323200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt. Laurel, NJ

Sources for this page

Verify at the official NPI Registry.