Individual provider Active NPI

Paul Edward Goldberg, M.D.

  • Internal Medicine Physician
  • Lawrenceville, NJ
National Provider Identifier
1316943574
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA33958 Issued in NJ
Practice address
3100 Princeton Pike
Lawrenceville, NJ 08648-2300
Phone
(609) 896-1793
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA33958 NJ Primary

Addresses

Primary practice location

3100 Princeton Pike
Lawrenceville, NJ 08648-2300

Mailing address

3100 Princeton Pike
BLDG 3, 3Rd Floor
Lawrenceville, NJ 08648-2300
Phone (609) 896-1793

Other identifiers 1

IdentifierTypeStateIssuer
2169207MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100929000720 NJ Practitioner - Internal Medicine 1456300862 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA33958NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Healthcare Affiliated Physicians PC Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Princeton Healthcare Affiliated Physicians PC Internal Medicine Current Accepting new patients
Princeton Healthcare Affiliated Physicians PC Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

3100 Princeton Pike
Bldg 3
Lawrenceville, NJ 08648
Phone (609) 895-0775

5 Plainsboro Rd
Ste 300
Plainsboro, NJ 08536

1 Washington Blvd
Ste A
Trenton, NJ 08691
Phone (609) 448-4353

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1316943574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 PRINCETON PIKE",
            "address_2": "BLDG 3, 3RD FLOOR",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482300",
            "telephone_number": "609-896-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PRINCETON PIKE",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482300",
            "telephone_number": "609-896-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA33958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2169207",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.