Richard Seth Goldberg, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

030932 Issued in CT

Practice address

46 West Avon Rd
Suite 203
Avon, CT 06001

Phone

(860) 675-0262

NPI assigned

Sep 29, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 15, 2017 through Apr 15, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bristol Hospital Multi Specialty Group, Inc

  • General Practice Physician
  • Bristol, CT
  • NPI 1649265679
  NPD (past)
• Bristol Hospital Multi-Specialty Group, Inc.

  • Psychiatry Physician
  • Bristol, CT
  • NPI 1396734109
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154413920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 NEW RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-675-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 WEST AVON RD",
            "address_2": "SUITE 203",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-675-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "RICHARD",
        "middle_name": "SETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "030932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel John Gill, D.D.S., M.D.
• Thomas Adam Gilmore, RPH
• Brooke Giordano, APRN
• Carl Joseph Gisnarian, CCP, LP
• Ruth Goldbaum, A.P.R.N.
• Kellyn Ann Goldberger, MS, BCBA, LBA
• Marcia E Goldsholl, RD, MA, CD-N
• Walter M Gorack Jr., DPT, MBA, GCS
• Halina Gorecki, APRN
• Gorehab LLC

• Psychiatry Physician in Avon, CT
• Providers in Avon, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.