NPIMap

Individual provider Active NPI

Alyssa Rae Goldbach, D.O.

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1528446424
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS0202297 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-7237
Fax
(215) 707-9389
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X OP61628374 WA
Diagnostic Radiology Physician 2085R0202X OS0202297 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3500 N Broad St # 1a
Philadelphia, PA 19140-4106
Phone (215) 707-3411

Other practice location 1

1500 Lansdowne Ave
Darby, PA 19023-1200
Phone (610) 237-4000

Other practice location 2

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200611001463 PA Practitioner - Diagnostic Radiology 3577984962 Reassigns benefits to 7 organizations
I20250328002471 KY Practitioner - Diagnostic Radiology 3577984962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

1476 Salomon LN
Chesterbrook, PA 19087-1104
Phone (253) 761-4200

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0202297PAMDDiagnostic Radiology Physician
OP61628374WAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tra Medical Imaging Centers LLC CurrentSince Dec 1, 2025 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Dec 1, 2024 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Dec 1, 2024 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Radiology Associates of the Main Line P C Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 1, 2020 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Tra-Minw P S CurrentSince Dec 1, 2024 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Jul 1, 2020 Accepting new patients
Main Line Health Imaging LP Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Main Line Health Imaging LP PastSince Jul 1, 2021 Accepting new patients
Sheridan Community Hospital Past Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 526-2200

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

2365 Heritage Center Dr
Furlong, PA 18925
Phone (215) 728-3883

120 Valley Green Ln
Kng of Prussa, PA 19406
Phone (610) 526-3000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

255 W Lancaster Ave
Ste 131
Paoli, PA 19301
Phone (610) 560-8060

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

2301 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 282-8000

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
#1A
Philadelphia, PA 19140

122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750

21110 Sr 410 E
Ste 110
Bonney Lake, WA 98391

5900 State Highway 303 NE
Bremerton, WA 98311
Phone (253) 459-6633

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

500 Lilly Rd NE
Ste 160
Olympia, WA 98506
Phone (360) 413-8383

11212 Sunrise Blvd E
Ste 200
Puyallup, WA 98374

222 15th Ave SE
Puyallup, WA 98372

3400 California Ave SW
Seattle, WA 98116
Phone (206) 320-3399

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

5919 100th St SW
Tacoma, WA 98499

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

Interoperability endpoints

  • Direct secure messaging: agoldbach526996@direct-ehr-ssmhc.com
  • FHIR API: https://app.meldrx.com/api/fhir/ei-trami

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 12

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": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1528446424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST # 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-7237",
            "fax_number": "215-707-9389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Lansdowne Ave",
            "address_purpose": "LOCATION",
            "city": "Darby",
            "state": "PA",
            "postal_code": "190231200",
            "country_code": "US",
            "telephone_number": "610-237-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 Fawcett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021900",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBACH",
        "first_name": "ALYSSA",
        "middle_name": "RAE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "OP61628374",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS0202297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.