Active NPI
Deborah Goldberg, M.D.
- Hospitalist Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 2015009594
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (630) 624-1468
- NPI assigned
- Apr 18, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036152013 | IL | |
| Internal Medicine Physician | 207R00000X | 2015009594 | MO | |
| Pediatrics Physician | 208000000X | 2015009594 | MO | |
| Hospitalist Physician | 208M00000X | 036152013 | IL | |
| Hospitalist Physician | 208M00000X | 2015009594 | MO | Primary |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (630) 624-1468
Other practice location 1
10010 Kennerly Rd
3 Southbridge
Saint Louis, MO 63128-2106
Phone (314) 525-1328
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326338849 | Medicaid | MO | |
| P01507980 | Other | MO | RAILROAD MEDICARE |
| P01507711 | Other | MO | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St Louis | Current | Accepting new patients | |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current | Accepting new patients |
| SSM Cardinal Glennon Children'S Hospital | Pediatrics | Current | Accepting new patients |
| SSM Health Care St. Louis | Current | Accepting new patients | |
| Cep America-Illinois Hospitalists, LLP | Internal Medicine | Current | Accepting new patients |
| SSM Cardinal Glennon Childrens Hospital | Pediatrics | Current | Accepting new patients |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Cep America-Illinois Hospitalists | Hospitalist | Current | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
10010 Kennerly Rd
#3
Saint Louis, MO 63128
Phone (314) 525-1328
615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
Organizations & group practices 8
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.
-
- Internal Medicine Physician
- Belleville, IL
- NPI 1841613403
-
- Clinic/Center
- Saint Louis, MO
- NPI 1851431738
-
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Pediatrics Physician
- Warrenton, MO
- NPI 1962573212
-
- Cardiovascular Disease Physician
- Bridgeton, MO
- NPI 1376598599
-
- Hospitalist Physician
- Bloomington, IL
- NPI 1669276523
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
-
- General Acute Care Hospital
- O Fallon, IL
- NPI 1629057302
-
- Critical Access Hospital
- Highland, IL
- NPI 1447352323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1326338849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "630-624-1468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "630-624-1468"
}
],
"practiceLocations": [
{
"address_1": "10010 Kennerly Rd",
"address_2": "3 Southbridge",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631282106",
"country_code": "US",
"telephone_number": "314-525-1328",
"fax_number": "314-525-1378",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLDBERG",
"first_name": "DEBORAH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-18",
"last_updated": "2022-06-09",
"certification_date": "2022-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036152013",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2015009594",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2015009594",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036152013",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MO",
"license": "2015009594",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1326338849",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01507980",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01507711",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.