Active NPI
Barry Goldberg, MD
- Family Medicine Physician
- Dix Hills, NY
National Provider Identifier
1033369673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 152301
- Practice address
- 517 Deer Park Rd
Dix Hills, NY 11746-5207 - Phone
- (631) 423-9100
- NPI assigned
- Sep 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 152301 | NY | Primary |
Addresses
Primary practice location
517 Deer Park Rd
Dix Hills, NY 11746-5207
Mailing address
517 Deer Park Rd
Dix Hills, NY 11746-5207
Phone (631) 423-9100
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152301 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221782400000",
"number": "1033369673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 DEER PARK RD",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117465207",
"telephone_number": "631-423-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 DEER PARK RD",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117465207",
"telephone_number": "631-423-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "BARRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-19",
"last_updated": "2008-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "152301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dix Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.