JACK D GOLDSTEIN (NPI# 1245233261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245233261 |
| Entity Type | Individual |
| Full Name | JACK D GOLDSTEIN |
| Credential | M.D.1208 |
| Practice Address |
400 Massasoit Ave Suite 201 E Providence RI 02914-2012 |
| Practice Telephone | 4019195222 |
| Practice Fax Number | 4019195227 |
| Mailing Telephone | 4019195222 |
| Mailing Fax Number | 4019195227 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | RI8073 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RI BLUE CROSS BLUE SHIELD | 0000022384 | 01 |
| RI | RI BLUE CHIP | 202113 | 01 |
| RI | HARVARD PILGRIM HEALTH CA | 61829 | 01 |
| RI | NEIGHBORHOOD HEALTH | 15131 | 01 |
| RI | TUFTS | 779577 | 01 |
| RI | 9020116 | 05 | |
| PR | UNITED HEALTHCARE | 0900689 | 01 |
| RI | RAILROAD MEDICARE | 200042974 | 01 |
| RI | AETNA US HEALTHCARE | 2432493 | 01 |
| RI | CIGNA | 2797369003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083822464 | Jack Goldstein | Counselor | 7464 W Sahara Ave, Suite #4, Las Vegas, NV 89117-2740 | 2007-05-18 |
| 1457443228 | Jack Goldstein | Internal Medicine | 325 N State of Franklin Rd, 2nd Floor, Johnson City, TN 37604 | 2006-09-29 |
| 1629051404 | Jack Goldstein | Optometrist | 418 38th St, Union City, NJ 07087-4806 | 2005-11-25 |
| 1114929858 | Jack Goldstein | Internal Medicine | 218c Sunset Rd, Willingboro, NJ 08046-1104 | 2005-08-12 |
| Street Address |
400 MASSASOIT AVE SUITE 201 |
| City | E PROVIDENCE |
| State | RI |
| Zip Code | 02914-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144606799 | Jessica Leblanc | Nurse Practitioner | 400 Massasoit Ave, Suite 300, E Providence, RI 02914-2012 | 2015-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427521830 | University Orthopedics, Inc. | Orthopaedic Surgery | 1351 Smith St Ste 103, North Providence, RI 02911-3340 | 2019-01-08 |
| 1811474224 | University Orthopedics, Inc. | Orthopaedic Surgery | 1598 S County Trl Ste 203, East Greenwich, RI 02818-1762 | 2018-07-27 |
| 1841741931 | Orthopedics Rhode Island, Inc | Orthopaedic Surgery | 268 Post Road, Westerly, RI 02891 | 2016-10-24 |
| 1730638404 | University Orthopedics, Inc. | Orthopaedic Surgery | 300 Industrial Way, Tiverton, RI 02878-3128 | 2016-09-23 |
| 1730430778 | Anthony Frank Merlino | Orthopaedic Surgery | 2 Country Side Drive, North Providence, RI 02904-3419 | 2012-10-01 |
| 1154682623 | John Walter Hayes | Orthopaedic Surgery | 220 Day Lily Cir, South Kingstown, RI 02879-5498 | 2012-05-31 |
| 1386948719 | Geret A Du Bois Md, Inc | Orthopaedic Surgery | 330 Cottage St, Pawtucket, RI 02860 | 2010-12-28 |
| 1851556849 | Stephan D Deutsch | Orthopaedic Surgery | 1 Wayland Ave Unit 316n, Providence, RI 02906-4565 | 2008-07-19 |
| 1215190152 | Robert J. Fortuna, Md,ltd | Orthopaedic Surgery | 211 Armistice Blvd, Pawtucket, RI 02860-3242 | 2008-07-09 |
| 1568642411 | Michael Anthony De Luca | Orthopaedic Surgery | 683 Neck Rd, Tiverton, RI 02878-4011 | 2007-11-08 |
| Find all providers with the same taxonomy | ||||
| City | E PROVIDENCE |
| Zip Code | 02914 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.