Mark Daniel Goldberg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18592 Issued in AZ

Practice address

5252 E Main St
Mesa, AZ 85205-8022

Phone

(480) 396-3222

Fax

(480) 396-2298

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Family Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21654/brand/1/csg/1/fhir/r4
• Direct secure messaging: mark.goldberg.1@19654.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/22064/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/19654/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group NPD
• Mark D Goldberg, MD, PC

  dba Velda Rose Medical Center

  • Clinic/Center
  • Mesa, AZ
  • NPI 1841482601
  Authorized official Same address or phone
• Allen Family Medicine PLLC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1356614176
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1144238312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058022",
            "telephone_number": "480-396-3222",
            "fax_number": "480-396-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058022",
            "telephone_number": "480-396-3222",
            "fax_number": "480-396-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "18592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298704",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Goh
• Janessa Gojkovich, SLPA
• Gold Canyon Internal Medicine, PLLC
• Lisa Loree Gold, PH.D.
• Kimberly Goldberg, PHARMD
• Amanda Lael Golde, LMT
• Golden Health at Home Personal Care Services LLC
• Golden Rose Hospice Care Inc
• Golden Years Care Home, LLC
• Golden Years Physical Therapy LLC

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
• 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.