Individual provider Active NPI

Jonathan Goldberg

  • Internal Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1396072948
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57017253 Issued in OH
Practice address
4777 E Galbraith Rd
Cincinnati, OH 45236-2725
Phone
(513) 686-5446
Fax
(513) 686-5443
NPI assigned
Nov 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME112052 FL
Internal Medicine Physician 207R00000X 57017253 OH Primary

Addresses

Primary practice location

4777 E Galbraith Rd
Cincinnati, OH 45236-2725

Mailing address

4777 E Galbraith Rd
Cincinnati, OH 45236-2725
Phone (513) 686-5446

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgoldberg130061@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120628000523 FL Practitioner - Internal Medicine 4789849571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Hospitalists IncGroup PAC ID 9436157831, 179 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57017253OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Collins Physician Services, LLC Internal Medicine CurrentSince Aug 4, 2022 Accepting new patients
Eastside Hospitalists Inc CurrentSince Feb 1, 2016 Accepting new patients

Locations

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: jgoldberg130061@mhsdirect.net

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 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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1396072948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 E GALBRAITH RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362725",
            "telephone_number": "513-686-5446",
            "fax_number": "513-686-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 E GALBRAITH RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362725",
            "telephone_number": "513-686-5446",
            "fax_number": "513-686-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-03",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME112052",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57017253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgoldberg130061@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.