Individual provider Active NPI

Jonathan Edward Goldstein, M.D.

  • Interventional Cardiology Physician
  • Newark, NJ
National Provider Identifier
1679532287
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
68488 Issued in WI
Practice address
268 Martin Luther King Jr Blvd
5TH Floor
Newark, NJ 07102-2011
Phone
(973) 877-5463
Fax
(973) 877-2567
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA39764 NJ
Interventional Cardiology Physician 207RI0011X 68488 WI Primary

Addresses

Primary practice location

268 Martin Luther King Jr Blvd
5TH Floor
Newark, NJ 07102-2011

Mailing address

769 Northfield Ave
Suite 220
West Orange, NJ 07052-1198
Phone (973) 731-9442

Other identifiers 1

IdentifierTypeStateIssuer
1512404MedicaidNJ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA39764NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan E. Goldstein MD Interventional Cardiology CurrentSince Jan 1, 1990 Accepting new patients
Diagnostic & Clinical Cardiology, PA Interventional Cardiology Past Accepting new patients
Ekg Interpretation Group Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1679532287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE",
            "address_2": "SUITE 220",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521198",
            "telephone_number": "973-731-9442",
            "fax_number": "973-731-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 MARTIN LUTHER KING JR BLVD",
            "address_2": "5TH FLOOR",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022011",
            "telephone_number": "973-877-5463",
            "fax_number": "973-877-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA39764",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "68488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1512404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.