Individual provider Active NPI

Roy Jeffrey Goldberg, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Bronx, NY
National Provider Identifier
1962514034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
156644 Issued in NY
Practice address
2000 E Gun Hill Rd
Bronx, NY 10469-6016
Phone
(718) 405-3535
Fax
(718) 405-3501
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 156644 NY Primary

Addresses

Primary practice location

2000 E Gun Hill Rd
Bronx, NY 10469-6016

Mailing address

Pob 483
Patterson, NY 12563
Phone (914) 262-4141

Other identifiers 1

IdentifierTypeStateIssuer
00948169MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20031104000304 NY Practitioner - Geriatric MedicinePractitioner - Internal Medicine 9436061819 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156644NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roy J. Goldberg, MD, PC Geriatric Medicine CurrentSince Jan 1, 2004 Accepting new patients
New Rochelle Medical Services, PC Division of OBGYN Past Accepting new patients
Bayberry Nursing Home Past Accepting new patients
Richard G. Karanfilian, M.D.,P.C. Past Accepting new patients

Locations

2000 E Gun Hill Rd
Bronx, NY 10469
Phone (718) 320-0400

40 Keogh Ln
#D
New Rochelle, NY 10805
Phone (914) 636-6200

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962514034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 483",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "12563",
            "telephone_number": "914-262-4141",
            "fax_number": "718-405-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E GUN HILL RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696016",
            "telephone_number": "718-405-3535",
            "fax_number": "718-405-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ROY",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "156644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00948169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.