Individual provider Active NPI

Justin Daniel Golden, M.D.

  • Family Medicine Physician
  • Richfield, MN
National Provider Identifier
1659698512
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54115 Issued in MN
Practice address
6440 Nicollet Ave
Richfield, MN 55423-1697
Phone
(612) 861-1622
Fax
(612) 861-2307
NPI assigned
Apr 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 256931 MA
Family Medicine Physician 207Q00000X 54115 MN Primary

Addresses

Primary practice location

6440 Nicollet Ave
Richfield, MN 55423-1697

Mailing address

2854 Highway 55 Ste 130
Eagan, MN 55121-1447
Phone (651) 842-3349

Other identifiers 1

IdentifierTypeStateIssuer
54115OtherMNMN MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20110920000930 MN Practitioner - Family Practice 7719158955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richfield Medical Group LTDGroup PAC ID 9032154497, 7 clinicians

Practice addresses (Care Compare)

44 W 66TH St
Richfield, MN 55423-2316

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54115MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richfield Medical Group LTD Family Medicine CurrentSince Mar 2, 2020 Accepting new patients
Fairview Pharmacy Services LLC PastSince Feb 9, 2020 Accepting new patients

Locations

6440 Nicollet Ave
Richfield, MN 55423
Phone (612) 210-7494

44 W 66th St
Unit 10
Richfield, MN 55423
Phone (612) 861-1622

Interoperability endpoints

  • Direct secure messaging: jgolden495810@fairview.direct-ci.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 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1659698512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2854 HIGHWAY 55 STE 130",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211447",
            "telephone_number": "651-842-3349",
            "fax_number": "651-842-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 NICOLLET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231697",
            "telephone_number": "612-861-1622",
            "fax_number": "612-861-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-30",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "256931",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "54115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN MEDICAL LICENSE",
            "identifier": "54115",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.