NPIMap

Organization Active NPI

Goldstar Medical Associates LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Malden, MA
National Provider Identifier
1821721978
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
GOLDSTAR MEDICAL ASSOCIATES LLC
Practice address
164 Webster St
Malden, MA 02148-4423
Phone
(339) 224-0961
NPI assigned
Jul 6, 2022
Last updated
Sep 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Mrs. Harriet J. Kasozi, NPNPI 1770777963
Title
Co-Worker
Phone
(781) 661-8969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary
Skilled Nursing Facility 314000000X

Addresses

Primary practice location

164 Webster St
Malden, MA 02148-4423

Mailing address

164 Webster St
Malden, MA 02148-4423
Phone (781) 661-8969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221122000679 MA Part B Supplier - Clinic/Group Practice 8527436641 Receives reassigned benefits from 13 practitioners
Practice locations: Newburyport, MA; Malden, MA
O20240315003209 NH Part B Supplier - Clinic/Group Practice 8527436641 Receives reassigned benefits from 4 practitioners
Practice locations: Rye, NH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1821721978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WEBSTER ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484423",
            "telephone_number": "781-661-8969",
            "fax_number": "781-723-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WEBSTER ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484423",
            "telephone_number": "339-224-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDSTAR MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "KASOZI",
        "authorized_official_first_name": "HARRIET",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CO-WORKER",
        "authorized_official_telephone_number": "781-661-8969",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.