Active NPI
Jay P Goldstein, O.D.
- Optometrist
- Memphis, TN
National Provider Identifier
1669872768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3168
- Practice address
- 6151 Poplar Ave
Memphis, TN 38119-4741 - Phone
- (901) 763-4393
- NPI assigned
- Aug 26, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3168 | TN | Primary |
Addresses
Primary practice location
6151 Poplar Ave
Memphis, TN 38119-4741
Mailing address
6151 Poplar Ave
Memphis, TN 38119-4741
Phone (901) 763-4393
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3168 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1669872768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6151 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381194741",
"telephone_number": "901-763-4393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6151 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381194741",
"telephone_number": "901-763-4393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "JAY",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-26",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "3168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.