Individual provider Active NPI

Allison Hope Goldberg, M.D.

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1174054407
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT213377 Issued in PA
Practice address
160 E Erie Ave
Pediatric Residency Program
Philadelphia, PA 19134-1011
Phone
(215) 427-5000
NPI assigned
Mar 27, 2017
Last updated
May 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MT213377 PA Primary

Addresses

Primary practice location

160 E Erie Ave
Pediatric Residency Program
Philadelphia, PA 19134-1011

Mailing address

160 E Erie Ave
Pediatric Residency Program
Philadelphia, PA 19134-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200630002590 PA Practitioner - Pediatric Medicine 7113340613 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT213377PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health Care Associates Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childen's Health Care Associates Inc. CurrentSince Jul 1, 2020 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Past Accepting new patients

Locations

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1174054407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "address_2": "PEDIATRIC RESIDENCY PROGRAM",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "address_2": "PEDIATRIC RESIDENCY PROGRAM",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ALLISON",
        "middle_name": "HOPE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT213377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.