NPIMap

Individual provider Active NPI

Craig Russell Goldstein, DOMD

  • Nephrology Physician
  • West Orange, NJ
National Provider Identifier
1700973203
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MB07799900 Issued in NJ
Practice address
111 Northfield Ave
Suite 311
West Orange, NJ 07052
Phone
(973) 325-2103
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MB07799900 NJ Primary

Addresses

Primary practice location

111 Northfield Ave
Suite 311
West Orange, NJ 07052

Mailing address

111 Northfield Avenue
Suite 311
West Orange, NJ 07052
Phone (973) 325-2103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000173 NJ Practitioner - NephrologyPractitioner - Internal Medicine 3274561204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nephrology Group PAGroup PAC ID 9133220825, 6 clinicians

Practice addresses (Care Compare)

111 Northfield Ave
Suite 311
West Orange, NJ 07052-4703
Phone (973) 325-2103

8100 Kennedy Blvd
North Bergen, NJ 07047-4254
Phone (201) 963-1077

Hospital & facility affiliations

  • DaVita Millburn Dialysis Dialysis facility, Millburn, NJ, CCN 312645
  • DaVita Jersey City Dialysis Dialysis facility, North Bergen, NJ, CCN 312545
  • DaVita Irvington Dialysis Dialysis facility, Irvington, NJ, CCN 312683
  • DaVita Dialysis at Palisades Medical Center Dialysis facility, North Bergen, NJ, CCN 312652
  • DaVita Hillside Dialysis Dialysis facility, Hillside, NJ, CCN 312587
  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074
  • Palisades Medical Center Hospital, North Bergen, NJ, CCN 310003
  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB07799900NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nephrology Group PA Nephrology CurrentSince Jul 1, 2007 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
3 Dimension Diagnostic Solutions Past Accepting new patients

Locations

142 Palisade Ave
Ste 210
Jersey City, NJ 07306
Phone (201) 659-0850

8100 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 656-4104

111 Northfield Ave
Ste 311
West Orange, NJ 07052
Phone (201) 325-2103

Interoperability endpoints

  • Direct secure messaging: craig.goldstein@direct.christhospital.md
  • Direct secure messaging: craig.goldstein.1@9736.direct.athenahealth.com

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 11

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1700973203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVENUE",
            "address_2": "SUITE 311",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-325-2103",
            "fax_number": "973-325-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVE",
            "address_2": "SUITE 311",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-325-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "CRAIG",
        "middle_name": "RUSSELL",
        "credential": "DOMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MB07799900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.