Individual provider Active NPI

Alan Lee Goldman, MD

  • Surgery Physician
  • Roswell, GA
National Provider Identifier
1326124330
Registry record updated Mar 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
O17806 Issued in GA
Practice address
2500 Hospital Blvd Ste 150
Roswell, GA 30076-4976
Phone
(770) 442-3117
Fax
(678) 701-1722
NPI assigned
Oct 31, 2006
Last updated
Mar 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X O17806 GA Primary

Addresses

Primary practice location

2500 Hospital Blvd Ste 150
Roswell, GA 30076-4976

Mailing address

2500 Hospital Blvd
Suite 150
Roswell, GA 30076
Phone (770) 442-3117

Other practice location 1

600 Professional Dr Ste 130
Lawrenceville, GA 30046-7638
Phone (770) 442-3117

Other practice location 2

6105 Peachtree Dunwoody Rd Ste C245
Sandy Springs, GA 30328-5911
Phone (770) 442-3117

Other practice location 3

1505 Northside Blvd Ste 3400
Cumming, GA 30041-8223
Phone (770) 442-3117

Other identifiers 1

IdentifierTypeStateIssuer
493528OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070111000204 GA Practitioner - General Surgery 9638179948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Michigan Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Fulton General Surgery, PCGroup PAC ID 9234111360, 2 clinicians

Practice addresses (Care Compare)

2500 Hospital Blvd
Suite 150
Roswell, GA 30076-4976
Phone (770) 442-3117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O17806GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Fulton General Surgery, PC Surgery CurrentSince Apr 1, 2015 Accepting new patients
CRH Clinic of Atlanta Surgery Past Accepting new patients

Locations

1505 Northside Blvd
Ste 3400
Cumming, GA 30041
Phone (678) 335-9223

600 Professional Dr
Ste 130
Lawrenceville, GA 30046
Phone (678) 225-5678

2500 Hospital Blvd
Ste 150
Roswell, GA 30076
Phone (770) 442-3117

6105 Peachtree Dunwoody Rd
Ste C245
Sandy Springs, GA 30328
Phone (770) 394-0007

755 Mount Vernon Hwy NE
Ste 120
Sandy Springs, GA 30328
Phone (404) 851-0029

4298 Atlanta Rd SE
Ste 320
Smyrna, GA 30080
Phone (470) 242-0717

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709337600000",
    "number": "1326124330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-442-3117",
            "fax_number": "678-701-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764976",
            "telephone_number": "770-442-3117",
            "fax_number": "678-701-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Professional Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467638",
            "country_code": "US",
            "telephone_number": "770-442-3117",
            "fax_number": "678-701-1722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6105 Peachtree Dunwoody Rd Ste C245",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303285911",
            "country_code": "US",
            "telephone_number": "770-442-3117",
            "fax_number": "678-701-1722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 Northside Blvd Ste 3400",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300418223",
            "country_code": "US",
            "telephone_number": "770-442-3117",
            "fax_number": "678-701-1722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "ALAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "O17806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "493528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.