Individual provider Active NPI

Randall Aaron Goldstein, DO

  • Pediatrics Physician
  • Olathe, KS
National Provider Identifier
1700802295
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29058 Issued in KS
Practice address
2111 E Kansas City Rd
Olathe, KS 66061-7050
Phone
(913) 220-5724
Fax
(913) 222-1907
NPI assigned
Jul 15, 2006
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29058 KS Primary

Addresses

Primary practice location

2111 E Kansas City Rd
Olathe, KS 66061-7050

Mailing address

2111 E Kansas City Rd
Olathe, KS 66061-7050
Phone (913) 220-5724

Other identifiers 1

IdentifierTypeStateIssuer
1700802295MedicaidMO

Other names 1

  • Randall Aaron Goldstein Other name

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
29058KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbodykc, LLC Pediatrics CurrentSince Sep 14, 2025 Accepting new patients

Locations

2111 E Kansas City Rd
Olathe, KS 66061
Phone (913) 220-5724

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1700802295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 E KANSAS CITY RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617050",
            "telephone_number": "913-220-5724",
            "fax_number": "913-222-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E KANSAS CITY RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617050",
            "telephone_number": "913-220-5724",
            "fax_number": "913-222-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "RANDALL",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "29058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700802295",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDALL",
            "last_name": "GOLDSTEIN",
            "middle_name": "AARON",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.