Individual provider Active NPI

Michael Ellis Goldberg, M.D.

  • Hospitalist Physician
  • New York, NY
National Provider Identifier
1215034673
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
225939 Issued in NY
Practice address
710 W 168TH Street
New York, NY 10032-2699
Phone
(212) 543-6931
Fax
(212) 543-5816
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 225939-1 NY
Hospitalist Physician 208M00000X 225939 NY Primary

Addresses

Primary practice location

710 W 168TH Street
New York, NY 10032-2699

Mailing address

710 W 168TH Street
New York, NY 10032-2699
Phone (212) 543-6931

Other identifiers 1

IdentifierTypeStateIssuer
02702298MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040814000175 NY Practitioner - Neurology 0941273379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225939-1NYMDNeurology Physician
225939NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Neurology Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2011 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2011 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

710 W 168th St
#1125A
New York, NY 10032
Phone (212) 342-4437

710 W 168th St
New York, NY 10032
Phone (212) 305-0217

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

51 W 51st St
Ste 360
New York, NY 10019
Phone (212) 326-8415

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: meg9017@direct.nyp.org

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1215034673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W 168TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322699",
            "telephone_number": "212-543-6931",
            "fax_number": "212-543-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W 168TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322699",
            "telephone_number": "212-543-6931",
            "fax_number": "212-543-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MICHAEL",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "225939-1",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "225939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02702298",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.