NPIMap

Individual provider Active NPI

Dana Meryl Goldenberg, PA-C

  • Medical Physician Assistant
  • El Segundo, CA
National Provider Identifier
1548695596
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
740 S Allied Way Ste D
El Segundo, CA 90245-5512
Phone
(310) 500-2045
Fax
(323) 305-7149
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

740 S Allied Way Ste D
El Segundo, CA 90245-5512

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other identifiers 1

IdentifierTypeStateIssuer
1112531OtherCANCCPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161101002680 CA Practitioner - Physician Assistant 2163700709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Seniors Group IncGroup PAC ID 1759769151, 53 clinicians

Practice addresses (Care Compare)

10000 Washington Blvd
Suite 108
Culver City, CA 90232-2782
Phone (888) 663-6331

740 S Allied Way
Suite D
El Segundo, CA 90245-5512
Phone (310) 500-2045

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Sep 17, 2016 Accepting new patients
St. Johns Community Health CurrentSince Sep 17, 2016 Accepting new patients
Saint John'S Health Clinic Past Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1548695596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S ALLIED WAY STE D",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455512",
            "telephone_number": "310-500-2045",
            "fax_number": "323-305-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "DANA",
        "middle_name": "MERYL",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1112531",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.