Individual provider Active NPI

Eric Goldman, D.C.

  • Chiropractor
  • Pomona, NY
National Provider Identifier
1811187586
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X003553-1 Issued in NY
Practice address
1540 Route 202
Suite 12
Pomona, NY 10970-2922
Phone
(845) 354-2100
Fax
(845) 354-2199
NPI assigned
Jul 30, 2007
Last updated
Apr 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X003553-1 NY Primary

Addresses

Primary practice location

1540 Route 202
Suite 12
Pomona, NY 10970-2922

Mailing address

1540 Route 202
Suite 12
Pomona, NY 10970-2922
Phone (845) 354-2100

Other identifiers 1

IdentifierTypeStateIssuer
X003553-1OtherNYSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110527000020 NY Practitioner - Chiropractic 3577740612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1540 Route 202
Suite 12
Pomona, NY 10970-2922
Phone (845) 354-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X003553-1NYMDChiropractor
003553NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Goldman, DC PC Chiropractor CurrentSince Mar 2, 2011 Accepting new patients

Locations

1540 Route 202
Ste 12
Pomona, NY 10970
Phone (845) 354-2100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1811187586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 ROUTE 202",
            "address_2": "SUITE 12",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702922",
            "telephone_number": "845-354-2100",
            "fax_number": "845-354-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 ROUTE 202",
            "address_2": "SUITE 12",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702922",
            "telephone_number": "845-354-2100",
            "fax_number": "845-354-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X003553-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "X003553-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.