Mark King Goldberg, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC002176L Issued in PA

Practice address

5638 Overbrook Ave
Philadelphia, PA 19131-1316

Phone

(215) 877-5770

Fax

(610) 660-9755

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306935432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 OVERBROOK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311316",
            "telephone_number": "215-877-5770",
            "fax_number": "610-660-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 OVERBROOK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311316",
            "telephone_number": "215-877-5770",
            "fax_number": "610-660-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MARK",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC002176L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Goldberg
• Lawrence Goldberg, MD
• Lee R Goldberg, MD
• Marc Bruce Goldberg, M.D.
• Marc Stewart Goldberg, M.D.
• Marybeth Goldberg
• Melvyn Goldberg, M.D.
• Myron B Goldberg, D.D.S.
• Rachel Goldberg
• Risa Goldberg

• Foot & Ankle Surgery Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• 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.