Individual provider Active NPI

Benjamin David Goldstein, M.D.

  • Pediatric Pulmonology Physician
  • Toledo, OH
National Provider Identifier
1861783680
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
35122743 Issued in OH
Practice address
2121 Hughes Dr Ste 640
Toledo, OH 43606-5131
Phone
(419) 291-2201
Fax
(419) 479-6998
NPI assigned
Apr 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 35122743 OH Primary

Addresses

Primary practice location

2121 Hughes Dr Ste 640
Toledo, OH 43606-5131

Mailing address

100 Madison Ave
Toledo, OH 43604-1516

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bgoldstein96608@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150708001423 OH Practitioner - Pediatric Medicine 5698087401 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35122743OHMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Jul 1, 2015 Accepting new patients
Promedica Children'S Specialists CurrentSince Aug 1, 2017 Accepting new patients
The Toledo Hospital CurrentSince Jan 27, 2024 Accepting new patients
The Toledo Hospital CurrentSince Jan 27, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Multicare Health System Past Accepting new patients
Toledo Childrens Hospital Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

20800 Harvard Rd
Fl 2
Highland Hills, OH 44122
Phone (216) 358-2156

1001 Bellefontaine Ave
Fl 2
Lima, OH 45804
Phone (419) 291-2719

830 W High St
Ste 307
Lima, OH 45801
Phone (419) 226-9694

2121 Hughes Dr
Ste 640
Toledo, OH 43606
Phone (419) 291-2207

2121 Hughes Dr
Ste 220
Toledo, OH 43606
Phone (419) 291-7403

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Interoperability endpoints

  • Direct secure messaging: bgoldstein96608@direct.promedica.org

Organizations & group practices 7

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1861783680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR STE 640",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065131",
            "telephone_number": "419-291-2201",
            "fax_number": "419-479-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "OH",
            "license": "35122743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgoldstein96608@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.