Organization Active NPI

Chelsea-Village Medical Office PC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
National Provider Identifier
1760593164
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
135098 Issued in NY
Legal business name
CHELSEA-VILLAGE MEDICAL OFFICE PC
Practice address
314 W 14TH St
New York, NY 10014-5002
Phone
(212) 929-9009
Fax
(212) 242-6057
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Authorized official

Name
Dr. Robert B. Goldberg, D.O.NPI 1558344309
Title
President
Phone
(212) 929-9009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 135098 NY Primary

Addresses

Primary practice location

314 W 14TH St
New York, NY 10014-5002

Mailing address

314 W 14TH St
New York, NY 10014-5002
Phone (212) 929-9009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080102000451 NY Part B Supplier - Clinic/Group Practice 7517858186 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

314 W 14th St
New York, NY 10014
Phone (212) 620-0144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1760593164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100145002",
            "telephone_number": "212-929-9009",
            "fax_number": "212-242-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W 14TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100145002",
            "telephone_number": "212-929-9009",
            "fax_number": "212-242-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHELSEA-VILLAGE MEDICAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-929-9009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "135098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.