Individual provider Active NPI

Carl Goldstein, MD

  • Nephrology Physician
  • Westfield, NJ
National Provider Identifier
1861497315
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MA38261 Issued in NJ
Practice address
215 North Ave W
Westfield, NJ 07090-1428
Phone
(908) 232-4321
Fax
(908) 232-7788
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA38261 NJ Primary

Addresses

Primary practice location

215 North Ave W
Westfield, NJ 07090-1428

Mailing address

77 Brant Ave
Suite 200
Clark, NJ 07066-1560
Phone (732) 382-0091

Other identifiers 1

IdentifierTypeStateIssuer
2000105MedicaidNJ

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
I20100315000034 NJ Practitioner - Nephrology 6800882184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Washington University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

215 N Ave
Westfield, NJ 07090
Phone (908) 756-4438

Hospital & facility affiliations

  • DaVita Summit Dialysis Dialysis facility, Mountainside, NJ, CCN 312528
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA38261NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Dec 15, 2015 Accepting new patients
Medical Diagnostic Associates, PA Past Accepting new patients

Locations

33 Bleeker St
Ste 104
Millburn, NJ 07041
Phone (973) 379-3051

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

215 North Ave W
Westfield, NJ 07090
Phone (908) 232-4321

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.

Hospital & facility affiliations 3

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1861497315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BRANT AVE",
            "address_2": "SUITE 200",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661560",
            "telephone_number": "732-382-0091",
            "fax_number": "732-382-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH AVE W",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901428",
            "telephone_number": "908-232-4321",
            "fax_number": "908-232-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA38261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, NJ

Sources for this page

Verify at the official NPI Registry.