Individual provider Active NPI

Thomas Spencer Goldbaum, M.D.

  • Cardiovascular Disease Physician
  • Chevy Chase, MD
National Provider Identifier
1275564593
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD-30885 Issued in MD
Practice address
5530 Wisconsin Ave
Suite 515
Chevy Chase, MD 20815-4404
Phone
(301) 656-4064
Fax
(410) 367-2069
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0030885 MD
Cardiovascular Disease Physician 207RC0000X MD-30885 MD Primary

Addresses

Primary practice location

5530 Wisconsin Ave
Suite 515
Chevy Chase, MD 20815-4404

Mailing address

5530 Wisconsin Ave
Suite 515
Chevy Chase, MD 20815-4404
Phone (301) 656-4064

Other identifiers 2

IdentifierTypeStateIssuer
32331400MedicaidMD
103252OtherMDMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040728001470 DC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7810967650 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0030885MDMDSpecialist
MD-30885MDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc CurrentSince Feb 22, 2014 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Feb 22, 2014 Accepting new patients
Medical Faculty Associates, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

6410 Rockledge Dr
Ste 200
Bethesda, MD 20817
Phone (301) 897-5301

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

Interoperability endpoints

  • Direct secure messaging: tgoldbaum53414@direct.hopkinsmedicine.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1275564593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE",
            "address_2": "SUITE 515",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154404",
            "telephone_number": "301-656-4064",
            "fax_number": "410-367-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE",
            "address_2": "SUITE 515",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154404",
            "telephone_number": "301-656-4064",
            "fax_number": "410-367-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBAUM",
        "first_name": "THOMAS",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0030885",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "MD-30885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32331400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "103252",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.