Individual provider Active NPI

Stephen Gilbert Goldberger

  • Nephrology Physician
  • Naples, FL
National Provider Identifier
1033167648
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
D0016646 Issued in MD
Practice address
878 109TH Ave N
Naples, FL 34108-1814
Phone
(239) 513-7930
Fax
(239) 513-1915
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X D0016646 MD Primary

Addresses

Primary practice location

878 109TH Ave N
Naples, FL 34108-1814

Mailing address

878 109TH Ave N
Naples, FL 34108-1814
Phone (239) 513-7930

Other identifiers 1

IdentifierTypeStateIssuer
115640300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0016646MDMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Nephrology Associates PC Nephrology Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7801 Old Branch Ave
Ste 202
Clinton, MD 20735
Phone (202) 221-8442

8926 Woodyard Rd
Ste 602
Clinton, MD 20735
Phone (301) 868-9244

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1033167648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "878 109TH AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341081814",
            "telephone_number": "239-513-7930",
            "fax_number": "239-513-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 109TH AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341081814",
            "telephone_number": "239-513-7930",
            "fax_number": "239-513-1915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERGER",
        "first_name": "STEPHEN",
        "middle_name": "GILBERT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0016646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115640300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.