Active NPI
Molly Jane Goloback, M.D.
- Emergency Medicine Physician
- Denver, CO
National Provider Identifier
1497983456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DR52113
- Practice address
- 777 Bannock St
Denver, CO 80204-4597 - Phone
- (303) 436-4949
- Fax
- (303) 602-5184
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125056427 | IL | |
| Emergency Medicine Physician | 207P00000X | DR52113 | CO | Primary |
Addresses
Primary practice location
777 Bannock St
Denver, CO 80204-4597
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other practice location 1
1375 E 19th Ave
Denver, CO 80218-1114
Phone (303) 338-4545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023406 | Other | CO | KAISER COMMERCIAL NUMBER |
| 20803273 | Medicaid | CO |
Other names 1
- Dr. Molly Jane Weiner
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130912000118 | CO | Practitioner - Emergency Medicine | 3971747049 | Reassigns benefits to 4 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Rush Medical College of Rush University, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1375 E 19TH Ave
Denver, CO 80218-1114
Phone (303) 812-2000
Hospital & facility affiliations
- Saint Joseph Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR52113 | CO | MD | Emergency Medicine Physician |
| 125056427 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ies Obs Colorado PLLC | Emergency Medicine | Current | Accepting new patients |
| Ies Colorado PLLC | Emergency Medicine | Current | Accepting new patients |
Locations
1375 E 19th Ave
Denver, CO 80218
Phone (303) 812-2000
Interoperability endpoints
- mgoloback8190@direct.dhha.org
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.
Hospital & facility affiliations 4
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": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1497983456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10350 E DAKOTA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802471314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 BANNOCK ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802044597",
"telephone_number": "303-436-4949",
"fax_number": "303-602-5184"
}
],
"practiceLocations": [
{
"address_1": "1375 E 19th Ave",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802181114",
"country_code": "US",
"telephone_number": "303-338-4545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLOBACK",
"first_name": "MOLLY",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-30",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125056427",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "DR52113",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER COMMERCIAL NUMBER",
"identifier": "023406",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20803273",
"state": "CO"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
"affiliation": "N",
"endpointDescription": "CAREQUALITY",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1375 E 19th Ave",
"city": "Denver",
"state": "CO",
"country_code": "US",
"postal_code": "802181114",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MOLLY",
"last_name": "WEINER",
"middle_name": "JANE",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.