Individual provider Active NPI

Russell Jay Goldstein, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1699112219
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT204473 Issued in PA
Practice address
245 N 15TH St
Philadelphia, PA 19102-1101
Phone
(215) 762-2365
NPI assigned
May 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT204473 PA Primary

Addresses

Primary practice location

245 N 15TH St
Philadelphia, PA 19102-1101

Mailing address

12 Franklin Valley Cir
Reisterstown, MD 21136-5812
Phone (410) 790-0521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20160727002018 DC Practitioner - Emergency Medicine 1850684978 Reassigns benefits to 1 organization
I20160826000999 VA Practitioner - Emergency Medicine 1850684978 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Associates P.a., P.C.Group PAC ID 8022914522, 706 clinicians

Practice addresses (Care Compare)

24440 Stone Springs Blvd
Dulles, VA 20166-2247
Phone (240) 686-2300

Hospital & facility affiliations

  • Virginia Hospital Center Hospital, Arlington, VA, CCN 490050

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT204473PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Dec 17, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 25, 2016 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Jul 25, 2016 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jul 25, 2016 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Dec 17, 2019 Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

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 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": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1699112219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FRANKLIN VALLEY CIR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211365812",
            "telephone_number": "410-790-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N 15TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021101",
            "telephone_number": "215-762-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "RUSSELL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT204473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.