NPIMap

Organization Active NPI

David M. Goldberg, PH.D., P.a.

  • Clinical Psychologist
  • Little Silver, NJ
National Provider Identifier
1043532161
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00345400 Issued in NJ
Legal business name
DAVID M. GOLDBERG, PH.D., P.A.
Practice address
34 Sycamore Ave
Building 2
Little Silver, NJ 07739-1228
Phone
(732) 576-8925
Fax
(732) 576-8814
NPI assigned
Feb 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Authorized official

Name
Dr. David Michael Goldberg, PH.D.NPI 1417009697
Title
President
Phone
(732) 576-8925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 35SI00345400 NJ Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 44SC05413400 NJ

Addresses

Primary practice location

34 Sycamore Ave
Building 2
Little Silver, NJ 07739-1228

Mailing address

34 Sycamore Ave
Building 2
Little Silver, NJ 07739-1228
Phone (732) 576-8925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100914000188 NJ Part B Supplier - Clinic/Group Practice 0749305878 Receives reassigned benefits from 4 practitioners
Practice locations: Little Silver, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1043532161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE AVE",
            "address_2": "BUILDING 2",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391228",
            "telephone_number": "732-576-8925",
            "fax_number": "732-576-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE AVE",
            "address_2": "BUILDING 2",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391228",
            "telephone_number": "732-576-8925",
            "fax_number": "732-576-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M. GOLDBERG, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-576-8925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00345400",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05413400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Silver, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.