Individual provider Active NPI

Shauna Eve Goldman, MD

  • Dermatology Physician
  • Dallas, TX
National Provider Identifier
1104245505
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R6564 Issued in TX
Practice address
2350 North Stemmons Freeway Suite 4200
Dallas, TX 75390-2045
Phone
(214) 456-5030
NPI assigned
Apr 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X R6564 TX
Dermatology Physician 207N00000X R6564 TX Primary

Addresses

Primary practice location

2350 North Stemmons Freeway Suite 4200
Dallas, TX 75390-2045

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (915) 549-2877

Other practice location 1

420 Camino Real Ave
El Paso, TX 79922-2045
Phone (915) 549-2877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R6564TXMDDermatology Physician

Interoperability endpoints

  • Direct secure messaging: shauna@elpasoderm.emadirect.md
  • Direct secure messaging: shauna.goldman.1@26814.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1104245505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "915-549-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 NORTH STEMMONS FREEWAY SUITE 4200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753902045",
            "telephone_number": "214-456-5030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Camino Real Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799222045",
            "country_code": "US",
            "telephone_number": "915-549-2877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "SHAUNA",
        "middle_name": "EVE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "TX",
            "license": "R6564",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "R6564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.