Individual provider Active NPI

Douglas Daniel Goldschmidt, LCSWR

  • Clinical Social Worker
  • East Syracuse, NY
National Provider Identifier
1770539496
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73 076016 Issued in NY
Practice address
305 Summerhaven Dr N
East Syracuse, NY 13057-3127
Phone
(315) 414-8896
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 73 076016 NY Primary

Addresses

Primary practice location

305 Summerhaven Dr N
East Syracuse, NY 13057-3127

Mailing address

305 Summerhaven Dr N
East Syracuse, NY 13057-3127
Phone (315) 414-8896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000615 NY Practitioner - Clinical Social Worker 8527046036 Practice locations: Syracuse, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

430 E Genesee St
Suite 110
Syracuse, NY 13202-2155
Phone (315) 424-0873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73 076016NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Healthcare, PLLC CurrentSince Jan 1, 2011 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
The Neighborhood Center, Inc. Clinical PastSince Dec 24, 2023 Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

600 E Genesee St
Ste 217
Syracuse, NY 13202
Phone (315) 452-0300

3300 James St
Ste 100
Syracuse, NY 13206

Interoperability endpoints

  • Direct secure messaging: douglasgoldschmidt@tdh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1770539496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SUMMERHAVEN DR N",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573127",
            "telephone_number": "315-414-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SUMMERHAVEN DR N",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573127",
            "telephone_number": "315-414-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSCHMIDT",
        "first_name": "DOUGLAS",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 076016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

Verify at the official NPI Registry.