Individual provider Active NPI

Kenneth A Goldman, M.D

  • Specialist
  • Plainsboro, NJ
National Provider Identifier
1821085937
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA060490 Issued in NJ
Practice address
5 Plainsboro Road
Suite 400
Plainsboro, NJ 08536-1913
Phone
(609) 936-9100
Fax
(609) 936-9700
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA060490 NJ Primary

Addresses

Primary practice location

5 Plainsboro Road
Suite 400
Plainsboro, NJ 08536-1913

Mailing address

5 Plainsboro Road,
Suite 400
Plainsboro, NJ 08536-1913
Phone (609) 921-7223

Other identifiers 1

IdentifierTypeStateIssuer
6383301MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20091111000675 NJ Practitioner - General Surgery 3072516582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Surgical Associates PAGroup PAC ID 7517933385, 8 clinicians

Practice addresses (Care Compare)

5 Plainsboro Rd
Plainsboro, NJ 08536-1915
Phone (609) 936-9100

5 Plainsboro Rd
Suite 400
Plainsboro, NJ 08536-1913

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1466
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA060490NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
On Site Cardiovascular Imaging Inc CurrentSince Aug 4, 2023 Accepting new patients
Princeton Specialty Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kenneth.goldman@psa.directbygreenway.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1821085937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PLAINSBORO ROAD,",
            "address_2": "SUITE 400",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-921-7223",
            "fax_number": "609-921-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PLAINSBORO ROAD",
            "address_2": "SUITE 400",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-936-9100",
            "fax_number": "609-936-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA060490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6383301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainsboro, NJ

Sources for this page

Verify at the official NPI Registry.