Individual provider Active NPI

Ilene G Goldman, MD

  • Emergency Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1215965280
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101053273 Issued in VA
Practice address
4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225
Phone
(757) 467-4200
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101053273 VA Primary

Addresses

Primary practice location

4092 Foxwood Dr
Suite 101
Virginia Beach, VA 23462-5225

Mailing address

PO Box 7549
Portsmouth, VA 23707-0549
Phone (757) 686-3508

Other identifiers 1

IdentifierTypeStateIssuer
6091431MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100723000607 VA Practitioner - Emergency Medicine 6709789183 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Florida College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Associates P.a., P.C.Group PAC ID 8022914522, 706 clinicians

Practice addresses (Care Compare)

3000 Coliseum Dr
Hampton, VA 23666-5963
Phone (757) 736-1000

Hospital & facility affiliations

  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101053273VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Emergency Medical Care, LTD. Emergency Medicine CurrentSince Aug 6, 2019 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Apr 1, 2012 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince Sep 28, 2022 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Jul 1, 2017 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2017 Accepting new patients
Emergency Physicians of Tidewater Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Tidewater Emergency Medical Care PastSince Feb 2, 2020 Accepting new patients

Locations

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

3000 Coliseum Dr
Hampton, VA 23666
Phone (757) 736-1000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

11803 Jefferson Ave
Newport News, VA 23606
Phone (757) 594-1000

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

12825 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 523-9800

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1215965280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7549",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237070549",
            "telephone_number": "757-686-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4092 FOXWOOD DR",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625225",
            "telephone_number": "757-467-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "ILENE",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101053273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6091431",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.