Individual provider Active NPI

Frederick D Goldman, MD

  • Pediatric Hematology & Oncology Physician
  • Birmingham, AL
National Provider Identifier
1124013826
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
29486 Issued in AL
Practice address
1600 7TH Ave S
Birmingham, AL 35233-1711
Phone
(205) 934-3795
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 28926 IA
Pediatrics Physician 208000000X 29486 AL
Pediatric Hematology & Oncology Physician 2080P0207X 29486 AL Primary

Addresses

Primary practice location

1600 7TH Ave S
Birmingham, AL 35233-1711

Mailing address

703 Volker HL
Birmingham, AL 35294-0001
Phone (205) 934-3795

Other identifiers 3

IdentifierTypeStateIssuer
109764MedicaidAL
0090753MedicaidIA
10024OtherIAWELLMARK BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090626000475 AL Practitioner - Pediatric Medicine 2264583582 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29486ALMDPediatrics Physician
28926IAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC Pediatrics CurrentSince Jun 1, 2009 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 1, 2009 Accepting new patients
Uahsf PC Department of Peds Hemoc Pediatrics Past Accepting new patients

Locations

703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1124013826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 VOLKER HL",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940001",
            "telephone_number": "205-934-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-934-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "FREDERICK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IA",
            "license": "28926",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "29486",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "AL",
            "license": "29486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109764",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090753",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "10024",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.