Pablo Goldberg, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

253209 Issued in NY

Practice address

1051 Riverside Drive
Unit 74 2ND Floor
New York, NY 10032

Phone

(646) 774-6318

Fax

(888) 757-4699

NPI assigned

Oct 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 28, 2024 through Mar 28, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: phg9001@direct.nyp.org

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1083604680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DRIVE",
            "address_2": "UNIT 74 2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "646-499-1456",
            "fax_number": "888-757-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DRIVE",
            "address_2": "UNIT 74 2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "646-774-6318",
            "fax_number": "888-757-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "PABLO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "043229",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "253209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1432294",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Ellis Goldberg, M.D.
• Michael J Goldberg, D.M.D.
• Monica Jean Goldberg, RPA-C
• Naomi Goldberg, M.D.
• Nieca Goldberg, MD
• Rachel Goldberg, LMSW
• Randal Ian Goldberg, M.D.
• Rebecca Goldberg, PA
• Robert Goldberg, O.D.
• Robert B Goldberg, D.O.

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.