Individual provider Active NPI

Gabriel Goldberger, MD

  • Child & Adolescent Psychiatry Physician
  • Stoughton, MA
National Provider Identifier
1366422750
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
44552 Issued in MA
Practice address
966C Park St
Stoughton, MA 02072-3650
Phone
(781) 341-3334
Fax
(781) 341-8141
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 44552 MA Primary

Addresses

Primary practice location

966C Park St
Stoughton, MA 02072-3650

Mailing address

PO Box 1114
Lakeville, MA 02347-1114
Phone (508) 763-9299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080516000170 MA Practitioner - Psychiatry 4789753765

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44552MAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Child & Adolescent Psychiatry CurrentSince Mar 15, 2019 Accepting new patients
Good Samaritan Medical Practice Corp Past Accepting new patients
Stuart M Kameny MD Past Accepting new patients
Lisa M Lynch, Licsw LLC Past Accepting new patients

Locations

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

Interoperability endpoints

  • Direct secure messaging: ggoldberger252622@direct.bilh.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366422750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1114",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023471114",
            "telephone_number": "508-763-9299",
            "fax_number": "508-763-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966C PARK ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723650",
            "telephone_number": "781-341-3334",
            "fax_number": "781-341-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERGER",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "44552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

Verify at the official NPI Registry.