Individual provider Active NPI

Marvin Goldman, MD

  • Pediatric Adolescent Medicine Physician
  • East Brunswick, NJ
National Provider Identifier
1821183336
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MA28852 Issued in NJ
Practice address
33 Brunswick Woods Drive
East Brunswick, NJ 08816
Phone
(732) 257-4330
Fax
(732) 257-5986
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MA28852 NJ Primary

Addresses

Primary practice location

33 Brunswick Woods Drive
East Brunswick, NJ 08816

Mailing address

33 Brunswick Woods Drive
East Brunswick, NJ 08816
Phone (732) 257-4330

Other identifiers 2

IdentifierTypeStateIssuer
222130958OtherNJTAX ID
0775509MedicaidNJ

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
I20170622001299 NJ Practitioner - Pediatric Medicine 8921394396 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA28852NJMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Apr 23, 2017 Accepting new patients
Advocare , LLC CurrentSince Apr 23, 2017 Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

33 Brunswick Woods Dr
East Brunswick, NJ 08816
Phone (732) 257-4330

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1821183336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BRUNSWICK WOODS DRIVE",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "08816",
            "telephone_number": "732-257-4330",
            "fax_number": "732-257-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BRUNSWICK WOODS DRIVE",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "08816",
            "telephone_number": "732-257-4330",
            "fax_number": "732-257-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA28852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "222130958",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0775509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.