Individual provider Active NPI

Marcy C. Goldberg, N.P.

  • Nurse Practitioner
  • French Camp, CA
National Provider Identifier
1295848968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
399698 Issued in CA
Practice address
500 W. Hospital Rd.
French Camp, CA 95231
Phone
(209) 468-6937
Fax
(209) 468-7042
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 399698 CA Primary

Addresses

Primary practice location

500 W. Hospital Rd.
French Camp, CA 95231

Mailing address

PO Box 1020
Stockton, CA 95201-3120
Phone (209) 468-6937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050930000846 CA Practitioner - Nurse Practitioner 9830124551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
53.98 of 100Reported as group
Quality
11.8
Promoting interoperability
74
Improvement activities
0
Cost
82.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
399698CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Joaquin CurrentSince Mar 26, 2011 Accepting new patients
San Joaquin Faculty Medical Group CurrentSince Mar 26, 2011 Accepting new patients
County of San Joaquin CurrentSince Mar 26, 2011 Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295848968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1020",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952013120",
            "telephone_number": "209-468-6937",
            "fax_number": "209-468-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W. HOSPITAL RD.",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "95231",
            "telephone_number": "209-468-6937",
            "fax_number": "209-468-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MARCY",
        "middle_name": "C.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "399698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in French Camp, CA

Sources for this page

Verify at the official NPI Registry.