Joseph G. Goldberg, OD
Individual provider Active NPI Optometrist · Wilmington, DE
NPI 1093772683 · NPPES record last updated Jun 12, 2013
Key facts
- NPI
- 1093772683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- I30001134 (DE)
- Practice address
- 801 E Newport Pike
Wilmington, DE 19804-1920 - Phone
- (302) 999-1286
- Fax
- (302) 999-1162
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080303000151 | DE | Practitioner - Optometry | 0547344426 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I30001134 | DE | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilmington Family Eye Care LLC | Current |
Accepting new patients |
Locations
801 E Newport Pike
Wilmington, DE 19804
Phone (302) 999-1286
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | I30001134 | DE | Yes |
Addresses
Primary practice location
801 E Newport Pike
Wilmington, DE 19804-1920
Mailing address
801 E Newport Pike
Wilmington, DE 19804-1920
Phone (302) 999-1286
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NV1667 | Other | DC | MID ATLANTIC |
| 510291543 | Other | DE | UNITEDHEALTHCARE |
| 4365417 | Other | DE | AETNA |
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.