Active NPI
Michael Goldfarb, MD
- Gastroenterology Physician
- Maplewood, NJ
National Provider Identifier
1720062227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 25MA03861200
- Practice address
- 2130 Millburn Ave
C6
Maplewood, NJ 07040-3725 - Phone
- (973) 762-8200
- Fax
- (973) 762-8203
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 25MA03861200 | NJ | Primary |
Addresses
Primary practice location
2130 Millburn Ave
C6
Maplewood, NJ 07040-3725
Mailing address
2130 Millburn Ave
Suite C6
Maplewood, NJ 07040-3725
Phone (973) 762-8200
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4094729 | Other | NJ | AETNA |
| 443321 | Other | NJ | CIGNA |
| P1550250 | Other | NJ | OXFORD |
| 0203505 | Medicaid | NJ | |
| 276566 | Other | NJ | UNITED HEALTH CARE |
| 636266 | Other | NJ | FIRST HEALTH |
| F03666 | Other | NJ | HEALTHNET |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03861200 | NJ | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1720062227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 MILLBURN AVE",
"address_2": "SUITE C6",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403725",
"telephone_number": "973-762-8200",
"fax_number": "973-762-8203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 MILLBURN AVE",
"address_2": "C6",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403725",
"telephone_number": "973-762-8200",
"fax_number": "973-762-8203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDFARB",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NJ",
"license": "25MA03861200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4094729",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "443321",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P1550250",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0203505",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "276566",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "636266",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "F03666",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.