Steven I Goodman OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT005113 Issued in NY

Legal business name

STEVEN I GOODMAN OD PC

Practice address

1643 Route 112 Ste a
Medford, NY 11763-3654

Phone

(631) 758-5575

Fax

(631) 758-5579

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Steven I Goodman, O.D.NPI 1316146673

Title

Dr.

Phone

(631) 758-5575

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• family eyecare of medford Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven I Goodman, O.D.

  • Optometrist
  • Medford, NY
  • NPI 1316146673
  Medicare reassignment NPD Authorized official
• Mauricio Mendez Sandoval, OD

  • Student in an Organized Health Care Education/Training Program
  • Medford, NY
  • NPI 1417817230
  NPD
• Jewel Brown-Crosswell, OD

  • Optometrist
  • Medford, NY
  • NPI 1538082359
  NPD (past)
• Nagwa Ibrahim, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1790297638
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1992707491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 ROUTE 112 STE A",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633654",
            "telephone_number": "631-758-5575",
            "fax_number": "631-758-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 ROUTE 112 STE A",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633654",
            "telephone_number": "631-758-5575",
            "fax_number": "631-758-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN I GOODMAN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "631-758-5575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005113",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "VUT005113",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NY",
            "license": "VUT005113",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "NY",
            "license": "VUT005113",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "NY",
            "license": "VUT005113",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "VUT005113",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "NY",
            "license": "VUT005113",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03155837",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "family eyecare of medford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natale F Spata, D.C.
• Felicia Splaine
• Crystal Lynn Stamm, RN
• Lauren Standridge, FNP-BC
• Alan Richard Stern, DPM
• Danielle Stewart
• Adrianna Gabrielle Stone
• Stop and Shop Supermarket Co LLC
• Roberta Sucarato, BSN, RN
• Lisa Sullivan, LCSW

• Optometrist in Medford, NY
• Providers in Medford, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.