Individual provider Active NPI

Mark Goldstein, MD

  • Rheumatology Physician
  • Staten Island, NY
National Provider Identifier
1679568885
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
143699 Issued in NY
Practice address
1478 Victory Blvd
Staten Island, NY 10301-3915
Phone
(718) 447-0055
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 143699 NY Primary

Addresses

Primary practice location

1478 Victory Blvd
Staten Island, NY 10301-3915

Mailing address

1478 Victory Blvd
Staten Island, NY 10301-3915
Phone (718) 447-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101027000642 NY Practitioner - Rheumatology 6204020969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
New York Medical College, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rheumatology Associates of Li LLPGroup PAC ID 6103810791, 10 clinicians

Practice addresses (Care Compare)

315 E Middle Country Rd
Smithtown, NY 11787-2829
Phone (631) 360-7778

554 E Main St
Riverhead, NY 11901-2671
Phone 6313607778301

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
82.29
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143699NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology Associates of Long Island, LLP CurrentSince Aug 1, 2015 Accepting new patients
Rheumatology Associates of L.I., LLP CurrentSince Aug 1, 2015 Accepting new patients
Rheumatology Associates of L.I., LLP Past Accepting new patients

Locations

554 E Main St
Riverhead, NY 11901
Phone (631) 360-7778

315 E Middle Country Rd
Smithtown, NY 11787
Phone (631) 360-7778

1200 South Ave
Ste 307
Staten Island, NY 10314
Phone (718) 698-3777

Interoperability endpoints

  • Direct secure messaging: mark.goldstein.p1@direct.rali.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 1

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1679568885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1478 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013915",
            "telephone_number": "718-447-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013915",
            "telephone_number": "718-447-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "143699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.