Active NPI
Shauna Eve Goldman, MD
- Dermatology Physician
- Dallas, TX
National Provider Identifier
1104245505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- R6564
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6564 | TX | MD | Dermatology Physician |
Interoperability endpoints
- shauna@elpasoderm.emadirect.md
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.