JACK GOLDSTEIN MD
NPI 1396430229
Emergency Medicine in Bloomington, MN
About Jack Goldstein Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK GOLDSTEIN MD (NPI 1396430229) is an individual emergency medicine provider in Bloomington, Minnesota, licensed in Minnesota (82048) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, is affiliated with M Health Fairview University Of Mn, and is a graduate of University Of Minnesota Medical School (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jack Goldstein Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Jack Goldstein reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bloomington, MN 55435
- Reassigned Medicare billing, Minnesota enrollment
- 328 clinicians in this Medicare group
Edina, MN 55435
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 clinicians in this Medicare group
Minneapolis, MN 55404
- Reassigned Medicare billing, Minnesota enrollment
- 1,247 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
M Health Fairview University Of Mn
Acute Care Hospitals · Minneapolis, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55435 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jack Goldstein's NPI number?
The NPI number for Jack Goldstein is 1396430229. It was assigned to this individual provider in the NPPES registry on April 6, 2023.
Where is Jack Goldstein located?
Jack Goldstein practices at 4300 Market Pte Dr Ste 100, Bloomington, MN 55435. The listed phone number is (952) 835-9880.
What is Jack Goldstein's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Jack Goldstein enrolled in Medicare?
Yes. Jack Goldstein is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jack Goldstein's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Goldstein reassigns Medicare benefits to 3 organizations: Emergency Physicians Professional Association (Bloomington, MN), Fairview Health Services (Edina, MN) and Hennepin Healthcare System, Inc (Minneapolis, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Goldstein's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jack Goldstein affiliated with any hospitals?
According to CMS data, Jack Goldstein is affiliated with M Health Fairview University Of Mn.
When was this NPI record last updated?
The NPPES record for Jack Goldstein was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jack Goldstein, MD · NPI 1396430229
Emergency Medicine physician in Bloomington, Minnesota. Individual provider, active in the CMS NPPES registry since April 6, 2023.
## Identity
- **NPI:** 1396430229 (Entity type: Individual)
- **Enumerated:** April 6, 2023
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 82048 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4300 MARKET PTE DR STE 100, Bloomington, MN 55435-5435
- **Phone:** (952) 835-9880 · **Fax:** (952) 835-9880
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Emergency Physicians Professional Association (NPI 1801871934, Bloomington, MN); Fairview Health Services (NPI 1770663031, Edina, MN); Hennepin Healthcare System, Inc (NPI 1962914333, Minneapolis, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 2023
## Record status
- **NPPES last updated:** July 10, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1396430229) · Data from the CMS NPPES public registry.