Jacob H Goldberger, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME 35410 Issued in FL

Practice address

4571 Colonial Blvd
Suite 210
Fort Myers, FL 33966-1156

Phone

(239) 274-7600

Fax

(239) 274-7601

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Genesiscare USA of Florida LLC

  • Urology Physician
  • Venice, FL
  • NPI 1316127152
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1093713489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "address_2": "PAYER CONTRACTING AND RELATIONS",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4571 COLONIAL BLVD",
            "address_2": "SUITE 210",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661156",
            "telephone_number": "239-274-7600",
            "fax_number": "239-274-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERGER",
        "first_name": "JACOB",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME 35410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00413910",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039133600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1278209",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "7365988",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL PROVIDER #",
            "identifier": "95439",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hardipsinh Gohil
• Tsutomu Goi, M.D.
• Goingstraighttohealth.Com LLC
• Jessica Robin Golda, RN, BSN, CPEN
• Kathryn L Goldberg, PT, DPT
• Golden Age Home Health Agency, Corp
• Golden Professional Therapy Corp
• Cassandra Golden, MS, RD
• Goldencare 4 U Home Health Agency Corp
• Sherri Dawn Golding, HHA

• Surgery Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.