MEDICARE: NOAH GOLDSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	2021-00365	NC
2	2084P0800X	Psychiatry Physician	DR.0070044	CO

General Provider Information

NPI Number	:	1538722590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH GOLDSTEIN MD

Provider Business Mailing Address
First Line	:	5277 MANHATTAN CIR STE 101
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-8200
Country	:	US
Telephone Number	:	919-200-0512
Fax Number	:	919-944-4381

Provider Business Practice Location Address
First Line	:	5277 MANHATTAN CIR STE 101
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80303-8200
Country	:	US
Telephone Number	:	919-200-0512
Fax Number	:	919-944-4381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2019
Last Update Date	:	07/09/2025

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