Michelle Goldberg Green, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

254117 Issued in NY

Practice address

115 E 61St St
Suite 7E
New York, NY 10065-8183

Phone

(212) 317-1100

Fax

(212) 317-1391

NPI assigned

May 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Kristal Goldberg Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Dermatology

Education

New York University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skinfocused Dermatology LLCGroup PAC ID 8426273590, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mig7010@direct.nyp.org

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.

• Skinfocused Dermatology LLC

  • Dermatology Physician
  • Rye, NY
  • NPI 1710391750
  Medicare reassignment Care Compare group NPD
• Stacy P Salob MD PLLC

  • Dermatology Physician
  • New York, NY
  • NPI 1487849865
  NPD

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1407023369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E 61ST ST",
            "address_2": "SUITE 7E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658183",
            "telephone_number": "212-317-1100",
            "fax_number": "212-317-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 61ST ST",
            "address_2": "SUITE 7E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658183",
            "telephone_number": "212-317-1100",
            "fax_number": "212-317-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHELLE",
        "middle_name": "GOLDBERG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "254117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GOLDBERG",
            "middle_name": "KRISTAL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Victoria Green, PA-C
• Merry Lyn Green, ANP
• Michael David Green, MD, D.ABA
• Michele Green, PHYSICIAN ASSISTANT
• Michele S Green, MD
• Mitchell Bruce Green, D.C.
• Nancy Green, LMSW
• Nancy Green
• Nikeechee Green
• Pauline Green, LICENSE MASTER SW

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.

Verify at the official NPI Registry.