Individual provider Active NPI

Jared S Gold, M.D.

  • Pediatrics Physician
  • North Miami, FL
National Provider Identifier
1851580997
Registry record updated Jan 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME110190 Issued in FL
Practice address
11645 Biscayne Blvd
Suite 103
North Miami, FL 33181-3155
Phone
(305) 538-8835
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME110190 FL Primary

Addresses

Primary practice location

11645 Biscayne Blvd
Suite 103
North Miami, FL 33181-3155

Mailing address

11645 Biscayne Blvd
Suite 207
North Miami, FL 33181-3155
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
003731100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160712000486 FL Practitioner - Pediatric Medicine 0749572774 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110190FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Beach Community Health Center Inc Current Accepting new patients
Miami Beach Community Health Center Inc CurrentSince May 16, 2016 Accepting new patients
Miami Beach Community Health Center, Inc. CurrentSince May 16, 2016 Accepting new patients

Locations

710 Alton Rd
Miami Beach, FL 33139

11645 Biscayne Blvd
Ste 103
North Miami, FL 33181

11645 Biscayne Blvd
Ste 207
North Miami, FL 33181
Phone (704) 297-9229

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.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484956800000",
    "number": "1851580997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD",
            "address_2": "SUITE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813155",
            "telephone_number": "305-538-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD",
            "address_2": "SUITE 103",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813155",
            "telephone_number": "305-538-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "JARED",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2017-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME110190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003731100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.