Active NPI
Stephanie Wrobel Goldberg, MD
- Neurology Physician
- Boston, MA
National Provider Identifier
1073742656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 272074
- Practice address
- 800 Washington St
Boston, MA 02111-1552 - Phone
- (617) 636-5000
- NPI assigned
- Jul 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 2015028017 | MO | |
| Neurology Physician | 2084N0400X | 272074 | MA | Primary |
Addresses
Primary practice location
800 Washington St
Boston, MA 02111-1552
Mailing address
660 S Euclid Ave
C B 8111
Saint Louis, MO 63110-1010
Phone (314) 362-7241
Other practice location 1
1600 S Brentwood Blvd
Suite 600
Saint Louis, MO 63144-1320
Phone (314) 362-7241
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
| License | State | Type | Specialty |
|---|---|---|---|
| 272074 | MA | MD | Neurology Physician |
| 2015028017 | MO | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1073742656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S EUCLID AVE",
"address_2": "C B 8111",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101010",
"telephone_number": "314-362-7241",
"fax_number": "314-362-0338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111552",
"telephone_number": "617-636-5000"
}
],
"practiceLocations": [
{
"address_1": "1600 S Brentwood Blvd",
"address_2": "Suite 600",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631441320",
"country_code": "US",
"telephone_number": "314-362-7241",
"fax_number": "314-362-0338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WROBEL GOLDBERG",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-05",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MO",
"license": "2015028017",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "272074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.