Individual provider Active NPI

Glenn Lee Goldstein, D.O.

  • Interventional Pain Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1811901044
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
185944 Issued in NY
Practice address
348 13TH St
Brooklyn, NY 11215-5004
Phone
(718) 788-7200
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 185944 NY Primary

Addresses

Primary practice location

348 13TH St
Brooklyn, NY 11215-5004

Mailing address

201 Sullivan St
Apt 4E
New York, NY 10012-4800
Phone (646) 379-0972

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000114 NY Practitioner - Pain ManagementPractitioner - General Practice 7517950025 Practice locations: Howard Beach, NY; Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
University of New England, College of Osteo Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

151 -44
Howard Beach, NY 11414-1777

15144 82ND St
Howard Beach, NY 11414-1777
Phone (718) 738-2550

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Olivares Physical Therapy, PC Past Accepting new patients
United Wellness Medical, P.C. Past Accepting new patients

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811901044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SULLIVAN ST",
            "address_2": "APT 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100124800",
            "telephone_number": "646-379-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 13TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155004",
            "telephone_number": "718-788-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "GLENN",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "185944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.