NPIMap

Individual provider Active NPI

Jay W. Goldberg, MD

  • Emergency Medicine Physician
  • Sonoma, CA
National Provider Identifier
1225141971
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A66617 Issued in CA
Practice address
347 Andrieux Street
Sonoma, CA 95476-6811
Phone
(707) 935-5100
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 14

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.

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petaluma Health Center Inc 76 clinicians
Coastal Health Alliance 40 clinicians

Practice addresses (Care Compare)

1179 N McDowell Blvd
Petaluma, CA 94954-6559
Phone (707) 559-7500

5900 State Farm Dr
Suite 200
Rohnert Park, CA 94928-2149
Phone (707) 559-7600

PO Box
Suite 910
Point Reyes Station, CA 94956-0910

Hospital & facility affiliations

  • Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20040204001069 CA Practitioner - Emergency Medicine 7012800931 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoma Valley Emergency Physicians Medical Group, Inc Emergency Medicine CurrentSince Nov 1, 2023 Accepting new patients
Sonoma Valley Emergency Physician Medical Group, Inc Emergency Medicine Past Accepting new patients
Pacific Redwood Medical Group Inc Emergency Medicine Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
Sonoma Valley Emergency Physicians Medical Group, Inc. Emergency Medicine Past Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
Seattle Emergency Physicians Services Inc PS Emergency Medicine Past Accepting new patients

Locations

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

Interoperability endpoints

  • Direct secure messaging: jgoldberg651113@direct.ochin.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A66617 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

347 Andrieux Street
Sonoma, CA 95476-6811

Mailing address

P.O. Box 10609
Westminster, CA 92685-0609
Phone (877) 818-6100

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00A666170MedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 2, 2008.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1225141971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10609",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926850609",
            "telephone_number": "877-818-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 ANDRIEUX STREET",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766811",
            "telephone_number": "707-935-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JAY",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A66617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A666170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonoma, CA

Sources for this page

Verify at the official NPI Registry.