Phillip B Goldblatt, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

113104 Issued in CT

Practice address

79 Trumbull St
New Haven, CT 06511-3708

Phone

(203) 624-1624

NPI assigned

Mar 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• State of Connecticut

  • Psychiatric Hospital
  • New Haven, CT
  • NPI 1881629434
  NPD (past)

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457480774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 TRUMBULL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113708",
            "telephone_number": "203-624-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 TRUMBULL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113708",
            "telephone_number": "203-624-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "PHILLIP",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "113104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole Taylor Goldberg, PSY.D.
• Daniel Goldberg, PA-C
• Philip Andrew Goldberg, MD
• Robin Goldberg, DENTIST
• Sarah B Goldberg, M.D., M.P.H.
• Laura Goldblum, LCSW
• Barbara Golden
• Marjorie P Golden, MD
• Brian Goldenberg, F.N.P
• Chaya M Goldenberg, LCSW

• Psychiatry Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.