Hayley Goldbach, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD17221 Issued in RI

Practice address

593 Eddy Street
Ambulatory Patient Center Apc 10
Providence, RI 02903-4626

Phone

(401) 444-7959

Fax

(401) 444-7144

NPI assigned

Jun 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Dermatology

Education

Pennsylvania State University College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Brown Dermatology IncGroup PAC ID 3870872773, 28 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.69 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

72.29

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Brown Dermatology, Inc.

  • Dermatology Physician
  • Providence, RI
  • NPI 1730538026
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group
• Lifespan Physician Group Inc

  • Urology Physician
  • Providence, RI
  • NPI 1720949803
  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Pediatrics

  NPD

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1154701019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "THE CHILDREN'S HOSPITAL OF PHILADELPHIA 9NW ROOM 55",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "AMBULATORY PATIENT CENTER APC 10",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034626",
            "telephone_number": "401-444-7959",
            "fax_number": "401-444-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBACH",
        "first_name": "HAYLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-05",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT208181",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "MD17221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Semsa Gogcu, M.D.
• Anupriya Gogne, MD
• Maya Gogtay, MD
• Ziya Levent Gokaslan, M.D.
• Richard L Gold, MD
• Amy Goldberg, MD
• Miriam Anna Rimm Goldberg, MD PHD
• Richard J Goldberg, MD
• Golden Hour Counseling
• Antoinette Golden, M.D.

• Dermatology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Dermatology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.