Active NPI
A Sandor Goldstein, MD
- Vascular Surgery Physician
- Janesville, WI
National Provider Identifier
1871646554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 30210
- Practice address
- 1000 Mineral Point Ave
Janesville, WI 53548-2940 - Phone
- (608) 756-6868
- Fax
- (608) 756-6289
- NPI assigned
- Jan 18, 2007
- 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 | 30210 | WI | Primary |
Addresses
Primary practice location
1000 Mineral Point Ave
Janesville, WI 53548-2940
Mailing address
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6868
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GOLDSASA | Other | WI | MERCYCARE INSURANCE |
| P00995128DB7792 | Other | WI | RR MEDICARE |
| 1871646554 | Medicaid | WI | |
| 31481700 | Medicaid | WI |
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 |
|---|---|---|---|
| 30210 | WI | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1871646554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MINERAL POINT AVE",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535482940",
"telephone_number": "608-756-6868",
"fax_number": "608-756-6289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MINERAL POINT AVE",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535482940",
"telephone_number": "608-756-6868",
"fax_number": "608-756-6289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "A",
"middle_name": "SANDOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WI",
"license": "30210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCYCARE INSURANCE",
"identifier": "GOLDSASA",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00995128DB7792",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871646554",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31481700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.