Jennifer Lee Goldstock, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F306334-1 Issued in NY

Practice address

654 Watervliet Shaker Rd
Suite 3
Latham, NY 12110

Phone

(518) 218-4454

Fax

(518) 380-2023

NPI assigned

Mar 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer L. Mager Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 5, 2017 through Oct 5, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Integrative Medical Associates of New York, PLLC

  • Family Medicine Physician
  • Delmar, NY
  • NPI 1518261163
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1962743831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 WATERVLIET SHAKER RD",
            "address_2": "SUITE 3",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-218-4454",
            "fax_number": "518-380-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 WATERVLIET SHAKER RD",
            "address_2": "SUITE 3",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-218-4454",
            "fax_number": "518-380-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTOCK",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306334-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MAGER",
            "middle_name": "L.",
            "credential": "ANP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Virginia Giugliano, MD
• Brian H Glick, PA-C
• Mikayla Glode, LMHC
• Allison Goldberg, MD
• Mark Goldman, DDS
• Golub Corporation
• David Goodcoff, D.D.S.
• Robin Renae Goss, OTRL
• Alexis Gould, OT
• Jill M. Graham, P.T.

• Adult Health Nurse Practitioner in Latham, NY
• Providers in Latham, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.