Charles Barry Goldberg, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD11101 Issued in OR

Practice address

7215 SE 13TH Ave
Portland, OR 97202

Phone

(503) 954-2187

Fax

(503) 238-7025

NPI assigned

May 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Evergreen Integrative Medicine, LLC

  • Health Service Clinic/Center
  • Portland, OR
  • NPI 1407237175
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1336107200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 SE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025803",
            "telephone_number": "503-954-2187",
            "fax_number": "503-238-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 SE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97202",
            "telephone_number": "503-954-2187",
            "fax_number": "503-238-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "CHARLES",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD11101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268490",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Gold, MD
• Steven A Gold, DDS
• David John Golda, PT
• Ana Goldberg
• Andrew Daniel Goldberg, M.D.
• Ellen Goldberg, MSW, LCSW
• Jason Goldberg
• Kathleen Bobowski Goldberg, MSW, LCSW
• Kenneth Charles Goldberg, MD
• Linn Goldberg, MD

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.