Individual provider Active NPI

Ruth D Goldberg, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Munster, IN
National Provider Identifier
1003801812
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01046373A Issued in IN
Practice address
901 Macarthur
Munster, IN 46321-2901
Phone
(219) 836-1600
NPI assigned
Sep 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01046373A IN Primary

Addresses

Primary practice location

901 Macarthur
Munster, IN 46321-2901

Mailing address

PO Box 10805
Merrillville, IN 46410-0805
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
200131920MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01046373AINMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1003801812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10805",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464100805",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "RUTH",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01046373A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200131920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.