Active NPI
Howard Goldstein, M.D.
- Internal Medicine Physician
- Baltimore, MD
National Provider Identifier
1790747251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D0069728
- Practice address
- 2700 Quarry Lake Dr
Suite 280
Baltimore, MD 21209-3742 - Phone
- (443) 471-3270
- Fax
- (443) 471-3272
- NPI assigned
- Apr 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | R8E93 | MO | |
| Internal Medicine Physician | 207R00000X | R8E93 | MO | |
| Family Medicine Physician | 207Q00000X | D0069728 | MD | |
| Internal Medicine Physician | 207R00000X | D0069728 | MD | Primary |
Addresses
Primary practice location
2700 Quarry Lake Dr
Suite 280
Baltimore, MD 21209-3742
Mailing address
2700 Quarry Lake Dr
Suite 280
Baltimore, MD 21209-3742
Phone (443) 471-3270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202315511 | Medicaid | MO |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0069728 | MD | MD | Family Medicine Physician |
| R8E93 | MO | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM St. Charles Clinic Medical Group, Inc. | Family Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Saint Charles, MO
- NPI 1811932973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264118400000",
"number": "1790747251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 QUARRY LAKE DR",
"address_2": "SUITE 280",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093742",
"telephone_number": "443-471-3270",
"fax_number": "443-471-3272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 QUARRY LAKE DR",
"address_2": "SUITE 280",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093742",
"telephone_number": "443-471-3270",
"fax_number": "443-471-3272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "HOWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-03",
"last_updated": "2010-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "MO",
"license": "R8E93",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "R8E93",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0069728",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0069728",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202315511",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.