Individual provider Active NPI

Jory J Goldberg, M.D.

  • Pulmonary Disease Physician
  • Monroe TWP, NJ
National Provider Identifier
1407841638
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MA36882 Issued in NJ
Practice address
18 Centre Dr
Suite 103
Monroe TWP, NJ 08831-1501
Phone
(609) 655-1700
Fax
(609) 655-4455
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA36882 NJ
Pulmonary Disease Physician 207RP1001X MA36882 NJ Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA03688200 NJ

Addresses

Primary practice location

18 Centre Dr
Suite 103
Monroe TWP, NJ 08831-1501

Mailing address

18 Centre Dr
Suite 103
Monroe TWP, NJ 08831-1501
Phone (609) 655-1700

Other identifiers 1

IdentifierTypeStateIssuer
0428906MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070220000548 NJ Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3870695976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 Centre Dr
Suite 103
Monroe Township, NJ 08831-1501
Phone (609) 655-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA36882NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jory Goldberg, MD PA Critical Care Medicine CurrentSince Oct 30, 2006 Accepting new patients

Locations

18 Centre Dr
Ste 103
Monroe Twp, NJ 08831
Phone (609) 655-1700

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6112/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jory.goldberg.1@6112.direct.athenahealth.com

Organizations & group practices 1

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 6

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1407841638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CENTRE DR",
            "address_2": "SUITE 103",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088311501",
            "telephone_number": "609-655-1700",
            "fax_number": "609-655-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CENTRE DR",
            "address_2": "SUITE 103",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088311501",
            "telephone_number": "609-655-1700",
            "fax_number": "609-655-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JORY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA36882",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "MA36882",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA03688200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0428906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe TWP, NJ

Sources for this page

Verify at the official NPI Registry.