Dana Joy Goldberg, M.D.
Individual provider Active NPI Pediatrics Physician · Wilmington, DE
NPI 1265589998 · NPPES record last updated Nov 22, 2021
Key facts
- NPI
- 1265589998
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 241893-1 (NY)
- Practice address
- 1600 Rockland Rd
Wilmington, DE 19803-3607 - Phone
- (800) 955-1919
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110325000678 | CA | Practitioner - Pediatric Medicine | 6901909043 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 241893-1 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 241893-1 | NY | Yes |
Addresses
Primary practice location
1600 Rockland Rd
Wilmington, DE 19803-3607
Mailing address
129 Schley Ave
Albertson, NY 11507-1712
Phone (914) 772-7946
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Wilmington, DE
- Samantha Evette Gogola
- Gokart Transportation LLC
- Gold Standard ABA de LLC
- Dennis Norman Gold
- Richard Meyer Gold
- Erika Justine Goldberg
- Joseph G. Goldberg
- Laura Ann Goldberg
- Michael B Goldberg
- Golden Hour Lactation, Inc
All providers in Wilmington, DE · Pediatrics Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.