Individual provider Active NPI

Carey A Goldenberg, M.S. OTR'L

  • Occupational Therapist
  • Seattle, WA
National Provider Identifier
1558471813
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00003262 Issued in WA
Practice address
4636 E Marginal Way S Ste B100
Seattle, WA 98134-2322
Phone
(120) 676-3035
Fax
(206) 762-0111
NPI assigned
Aug 30, 2006
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT00003262 WA
Occupational Therapist 225X00000X OT00003262 WA Primary

Addresses

Primary practice location

4636 E Marginal Way S Ste B100
Seattle, WA 98134-2322

Mailing address

4636 E Marginal Way S Ste B100
Seattle, WA 98134-2322
Phone (120) 676-3035

Other practice location 1

1705 S 324th Pl
Federal Way, WA 98003-8504
Phone (206) 393-8546

Other identifiers 3

IdentifierTypeStateIssuer
7683519MedicaidWA
1044731MedicaidWA
1396982385MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT00003262WAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1558471813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 E MARGINAL WAY S STE B100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981342322",
            "telephone_number": "120-676-3035",
            "fax_number": "206-762-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 E MARGINAL WAY S STE B100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981342322",
            "telephone_number": "120-676-3035",
            "fax_number": "206-762-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 S 324th Pl",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980038504",
            "country_code": "US",
            "telephone_number": "206-393-8546",
            "fax_number": "253-661-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "CAREY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "M.S. OTR'L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT00003262",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7683519",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1044731",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396982385",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.