Individual provider Active NPI

Stanley J Goldberg, M.D.

  • Surgery Physician
  • Peoria, AZ
National Provider Identifier
1346280443
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
11831 Issued in AZ
Practice address
13640 N Plaza del Rio Blvd
Ste 310
Peoria, AZ 85381-4846
Phone
(623) 876-3910
Fax
(623) 285-2612
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 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 11831 AZ Primary

Addresses

Primary practice location

13640 N Plaza del Rio Blvd
Ste 310
Peoria, AZ 85381-4846

Mailing address

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3910

Other identifiers 1

IdentifierTypeStateIssuer
227159MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20060308000183 AZ Practitioner - General SurgeryPractitioner - Vascular Surgery 5799726915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

14502 W Meeker Blvd
Banner Health Clinic
Sun City West, AZ 85375-5282
Phone (623) 524-4000

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Feb 1, 2012 Accepting new patients
Banner Arizona Medical Clinic LTD Current Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Nov 3, 2024 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Feb 1, 2012 Accepting new patients

Locations

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

13640 N Plaza del Rio Blvd
Ste 310
Peoria, AZ 85381
Phone (623) 876-3800

13760 N 93rd Ave
Ste 107
Peoria, AZ 85381
Phone (623) 876-3952

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

13640 N Plaza del Rio Blvd
Ste 230
Peoria, AZ 85381
Phone (623) 876-3810

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1346280443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3910",
            "fax_number": "623-285-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "address_2": "STE 310",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3910",
            "fax_number": "623-285-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "STANLEY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "11831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227159",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.