NPIMap

Individual provider Active NPI

Charles Goldenberg, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1083932297
Registry record updated Aug 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
267911 Issued in NY
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(212) 434-2624
NPI assigned
May 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 267911 NY
Nuclear Medicine Physician 207U00000X 30544 OK
Body Imaging Physician 2085B0100X 267911 NY
Diagnostic Radiology Physician 2085R0202X A166076 CA
Vascular & Interventional Radiology Physician 2085R0204X 267911 NY
Diagnostic Radiology Physician 2085R0202X 267911 NY Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

300 Community Dr
Manhasset, NY 11030-3816
Phone (212) 434-2624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210924000901 NY Practitioner - Diagnostic Radiology 0244661049 Reassigns benefits to 3 organizations
I20260325000415 NJ Practitioner - Diagnostic Radiology 0244661049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Englewood Radiologic Group P aGroup PAC ID 6901852300, 131 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

101 Hospital Rd
Patchogue, NY 11772-4870
Phone (201) 894-3480

171 E 84TH St
Apt 12H
New York, NY 10028-2080
Phone (201) 894-3480

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 894-3480

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267911NYMDNuclear Medicine Physician
30544OKMDNuclear Medicine Physician
A166076CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Nuclear Medicine CurrentSince Aug 29, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Diagnostic Radiology CurrentSince Jul 15, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Diagnostic Radiology CurrentSince Jul 15, 2021 Accepting new patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince Sep 25, 2025 Accepting new patients
South Nassau Communities Hospital Current Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp Body Imaging CurrentSince Aug 29, 2022 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1421 3rd Ave
New York, NY 10028
Phone (212) 744-5538

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

440 Merrick Rd
Oceanside, NY 11572
Phone (516) 255-8220

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

300 Community Dr
Plandome, NY 11030

9525 Queens Blvd
Frnt 2
Rego Park, NY 11374
Phone (718) 360-5522

2 Lincoln Ave
Rockville Ctr, NY 11570
Phone (516) 390-2850

1220 Hicksville Rd
Seaford, NY 11783

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: charlesgoldenberg@snch.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660348800000",
    "number": "1083932297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "212-434-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-08-13",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NY",
            "license": "267911",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "OK",
            "license": "30544",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "267911",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A166076",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "267911",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "267911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.