Kenneth N Goldberg, MD

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

Practice address

2650 Ridge Ave
Department of Radiology, G507
Evanston, IL 60201-1718

Phone

(847) 570-2487

Fax

(847) 570-2942

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Diagnostic Radiology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Simonmed Imaging Florida LLCGroup PAC ID 6608036108, 302 clinicians

Howard Simon MD PLLCGroup PAC ID 7214369966, 61 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

75.71

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

75.71

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (8 of 10)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Howard Simon MD PLLC

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1659930998

  IL

  Medicare reassignment Care Compare group NPD
• Simonmed Imaging Florida LLC

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1477830818

  IL

  Medicare reassignment Care Compare group NPD
• Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489

  IL

  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  IL

  Medicare reassignment NPD
• Illinois Bone and Joint Institute LLC

  • Orthopaedic Surgery Physician
  • Bannockburn, IL
  • NPI 1205922432

  IL

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Illinois Bone and Joint Institute, LLC

  • Orthopaedic Surgery Physician
  • Arlington Heights, IL
  • NPI 1962219568
  NPD
• Northshore University Healthsystem Faculty Practice Associates

  • Diagnostic Radiology Physician
  • Evanston, IL
  • NPI 1710140496
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265451603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY, G507",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2487",
            "fax_number": "847-570-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "DEPARTMENT OF RADIOLOGY, G507",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2487",
            "fax_number": "847-570-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "KENNETH",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gnogno MD Visiting Physician Group Inc.
• Polly Godfrey, MD
• Diane Christine Goebel, MD
• Joseph Golbus, M.D.
• Gold Coast Podiatry Center, LLC
• Lawrence Goldberg, MD
• Marla Goldberg, RPH
• Melissa D Goldberg, DPT
• Michael J. Goldberg, MD
• Golden Heart Care LLC

• All providers in Evanston, IL
• Neuroradiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.