Active NPI
Jan Paul Goldberg, MD
- Internal Medicine Physician
- Denver, CO
National Provider Identifier
1104204114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21715
- Practice address
- 816 Acoma Street
Unit 1113
Denver, CO 80204-4068 - Phone
- (303) 912-4900
- NPI assigned
- May 11, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21715 | CO | Primary |
Addresses
Primary practice location
816 Acoma Street
Unit 1113
Denver, CO 80204-4068
Mailing address
816 Acoma Street
Unit 1113
Denver, CO 80204-4068
Phone (303) 912-4900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1217157 | Medicaid | CO | |
| 21715 | Other | CO | COLORADO LICENSE |
| 21715 | Other | CO | COLORADO STATE LICENSE |
Other names 1
- Dr. JP Goldberg
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jan Paul Goldberg | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Methadone Clinic
- Denver, CO
- NPI 1700263183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451260800000",
"number": "1104204114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "816 ACOMA STREET",
"address_2": "UNIT 1113",
"city": "DENVER",
"state": "CO",
"postal_code": "802044068",
"telephone_number": "303-912-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 ACOMA STREET",
"address_2": "UNIT 1113",
"city": "DENVER",
"state": "CO",
"postal_code": "802044068",
"telephone_number": "303-912-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "JAN PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-11",
"last_updated": "2015-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "21715",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1217157",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO LICENSE",
"identifier": "21715",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO STATE LICENSE",
"identifier": "21715",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JP",
"last_name": "GOLDBERG",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.