Individual provider Active NPI

Jacob R Goldberg, MD

  • Hospitalist Physician
  • Pompton Plains, NJ
National Provider Identifier
1669670519
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA08706500 Issued in NJ
Practice address
97 W Parkway
Pompton Plains, NJ 07444-1647
Phone
(973) 831-5000
Fax
(973) 831-5432
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 244749 NY
Hospitalist Physician 208M00000X 244749 NY
Hospitalist Physician 208M00000X 25MA08706500 NJ Primary

Addresses

Primary practice location

97 W Parkway
Pompton Plains, NJ 07444-1647

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other identifiers 3

IdentifierTypeStateIssuer
0667910001OtherNYDME
P00421811OtherNYMEDICARE RAILROAD
02888411MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20070802000533 NY Practitioner - Internal Medicine 9436240694 Reassigns benefits to 2 organizations
I20241119002501 NJ Practitioner - Hospitalist 9436240694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Albert Einstein College of Medicine of Yeshiva University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

97 W Pkwy
2ND Floor
Pompton Plains, NJ 07444-1647
Phone (973) 831-5063

Hospital & facility affiliations

  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017
  • Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08706500NJMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2007 Accepting new patients
Practice Associates Medical Group Internal Medicine CurrentSince Nov 4, 2024 Accepting new patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2007 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Northern Westchester Hospital Association Past Accepting new patients

Locations

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

97 W Parkway
Fl 2
Pompton Plains, NJ 07444
Phone (908) 598-6610

97 W Parkway
Pompton Plns, NJ 07444
Phone (973) 831-5000

185 Route 312
Brewster, NY 10509
Phone (845) 225-2700

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

300 Community Dr
Plandome, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: jgoldberg66151@northwell.direct-ci.com

Organizations & group practices 5

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1669670519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 W PARKWAY",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441647",
            "telephone_number": "973-831-5000",
            "fax_number": "973-831-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JACOB",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "244749",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "244749",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA08706500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0667910001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00421811",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02888411",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

Verify at the official NPI Registry.