Individual provider Active NPI

David Goldenberg, M.D.

  • Plastic Surgery Physician
  • Danbury, CT
National Provider Identifier
1184629545
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
029132 Issued in CT
Practice address
107 Newtown Rd
2C
Danbury, CT 06810-4146
Phone
(203) 791-9661
Fax
(203) 730-4162
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 029132 CT
Plastic Surgery Physician 208200000X 029132 CT Primary

Addresses

Primary practice location

107 Newtown Rd
2C
Danbury, CT 06810-4146

Mailing address

107 Newtown Rd
2C
Danbury, CT 06810-4146
Phone (203) 791-9661

Other identifiers 1

IdentifierTypeStateIssuer
001291327MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Audiology & Hearing Aid Services PastSince Jun 1, 1998 Accepting new patients

Organizations & group practices 1

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1184629545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NEWTOWN RD",
            "address_2": "2C",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104146",
            "telephone_number": "203-791-9661",
            "fax_number": "203-730-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NEWTOWN RD",
            "address_2": "2C",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104146",
            "telephone_number": "203-791-9661",
            "fax_number": "203-730-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "029132",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "029132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001291327",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.