Individual provider Active NPI

Joseph G. Goldberg, OD

  • Optometrist
  • Wilmington, DE
National Provider Identifier
1093772683
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
I30001134 Issued in DE
Practice address
801 E Newport Pike
Wilmington, DE 19804-1920
Phone
(302) 999-1286
Fax
(302) 999-1162
NPI assigned
Apr 27, 2006
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X I30001134 DE Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080303000151 DE Practitioner - Optometry 0547344426 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I30001134DEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Family Eye Care LLC CurrentSince Jul 1, 2015 Accepting new patients

Locations

801 E Newport Pike
Wilmington, DE 19804
Phone (302) 999-1286

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1093772683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E NEWPORT PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198041920",
            "telephone_number": "302-999-1286",
            "fax_number": "302-999-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E NEWPORT PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198041920",
            "telephone_number": "302-999-1286",
            "fax_number": "302-999-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JOSEPH",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I30001134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.