Individual provider Active NPI

Scott Franklin Goldberg, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1255490264
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60801172 Issued in WA
Practice address
1100 9TH Ave
Ms:X6-Ort
Seattle, WA 98101-2756
Phone
(206) 223-7530
Fax
(206) 341-0195
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA17801 CA
Surgical Physician Assistant 363AS0400X PA60801172 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Ms:X6-Ort
Seattle, WA 98101-2756

Mailing address

1100 9TH Ave
Ms:M4-PFS
Seattle, WA 98101-2756
Phone (206) 515-5811

Other identifiers 2

IdentifierTypeStateIssuer
FT721AOtherCASA MEDICAL PHYSICIANS OF CA PTAN
MEDICAL LICENSEOtherCAPA 17801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180730001444 WA Practitioner - Physician Assistant 7911951298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

1344 Wintergreen LN NE
Bainbridge Island, WA 98110-5118
Phone (206) 842-5632

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

380 Winslow Way E
Bainbridge Island, WA 98110-2424
Phone (206) 842-5632

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

  • Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
17801CAMDPediatrics Physician
PA17801CAMDSurgical Physician Assistant
PA60801172WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Aug 9, 2018 Accepting new patients
Virginia Mason Medical Center CurrentSince Aug 9, 2018 Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

1100 9th Ave
#4
Seattle, WA 98101
Phone (206) 515-5811

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

1100 9th Ave
#6
Seattle, WA 98101
Phone (206) 223-6861

1100 9th Ave
#J11
Seattle, WA 98101

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

Organizations & group practices 3

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1255490264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "MS:M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-515-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "MS:X6-ORT",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-7530",
            "fax_number": "206-341-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "SCOTT",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA17801",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60801172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SA MEDICAL PHYSICIANS OF CA PTAN",
            "identifier": "FT721A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA 17801",
            "identifier": "MEDICAL LICENSE",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.