Active NPI
Jerry Goldstone, MD
- Vascular Surgery Physician
- Cleveland, OH
National Provider Identifier
1851325724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 35-076513
- Practice address
- 11100 Euclid Ave
Cleveland, OH 44106-1716 - Phone
- (216) 844-3013
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 35-076513 | OH | Primary |
Addresses
Primary practice location
11100 Euclid Ave
Cleveland, OH 44106-1716
Mailing address
24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363568 | Other | OH | WELLCARE |
| P00385110 | Other | OH | RAILROAD MEDICARE |
| 4419730 | Other | AETNA | |
| 2132801 | Medicaid | OH | |
| P00216359 | Other | OH | RAILROAD MEDICARE |
| 000000221401 | Other | OH | UNISON |
| 745999 | Other | OH | BUCKEYE |
| 000000503634 | Other | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-076513 | OH | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1851325724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24701 EUCLID AVE",
"address_2": "3RD FLOOR",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "216-844-3013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTONE",
"first_name": "JERRY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "OH",
"license": "35-076513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "363568",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00385110",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4419730",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2132801",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00216359",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "000000221401",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE",
"identifier": "745999",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000503634",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.