Tyler Goldberg

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

301 Hospital Dr
Glen Burnie, MD 21061-5803

Phone

(410) 787-4000

NPI assigned

Apr 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgoldberg532265@direct.umm.edu

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.

• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment Care Compare group
• St Agnes Healthcare Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176
  Medicare reassignment NPD
• University of Maryland St. Joseph Medical Group, LLC

  • General Practice Physician
  • Towson, MD
  • NPI 1770836785
  Medicare reassignment NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc

  • Internal Medicine Physician
  • Owings Mills, MD
  • NPI 1073940912
  NPD
• St Agnes Healthcare Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1780615922
  NPD
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  Care Compare affiliation

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1104389345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 WOODLAND DR",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210931519",
            "telephone_number": "443-415-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenard Medical Services, PA
• Glensan Wellness and Laser Pain Center
• Gloria Kidz Dental LLC
• Gold Shield Medical Services LLC
• Marjorie Lynne Gold
• Andrew Robert Goldberger, CRNP
• Goldman & Packman
• Stephen A. Goldman, D.D.S.
• Joseph Anthony Goldschmidt, PHARM.D.
• Luis Emilio Gomez Sr., M.D.

• Medical Physician Assistant in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.