Active NPI
Terry Jan Goldman, D.P.M.
- Podiatrist
- Hollywood, FL
National Provider Identifier
1902893712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO1410
- Practice address
- 10630 Paris St
Hollywood, FL 33026-4817 - Phone
- (305) 558-4004
- Fax
- (954) 437-2733
- NPI assigned
- Oct 6, 2005
- Last updated
- Mar 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO1410 | FL | Primary |
Addresses
Primary practice location
10630 Paris St
Hollywood, FL 33026-4817
Mailing address
10630 Paris St
Hollywood, FL 33026-4817
Phone (305) 558-4004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041362300 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1410 | FL | MD | Optician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Podiatrist
- Cooper City, FL
- NPI 1881831378
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236816000000",
"number": "1902893712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10630 PARIS ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330264817",
"telephone_number": "305-558-4004",
"fax_number": "954-437-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10630 PARIS ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330264817",
"telephone_number": "305-558-4004",
"fax_number": "954-437-2733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "TERRY",
"middle_name": "JAN",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2009-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "FL",
"license": "PO1410",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041362300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.