Iliya Goldberg, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A170915 Issued in CA

Practice address

401 E Highland Ave Ste 351
San Bernardino, CA 92404-3830

Phone

(909) 475-8611

Fax

(909) 475-2566

NPI assigned

Apr 18, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Un of California, Irvine, College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Bariatric a Medical CorporationGroup PAC ID 3476607052, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129
• Parkview Community Hospital Medical Center Hospital, Riverside, CA, CCN 050102

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Western Bariatric, a Medical Corporation

  • Surgery Physician
  • San Bernardino, CA
  • NPI 1184821373
  Medicare reassignment Care Compare group NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Highland, CA
  • NPI 1053653873
  NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Dignity Health

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  NPD (past)
• Doctors Hospital of Riverside LLC

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1124596382
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  Care Compare affiliation
• Doctors Hospital of Riverside LLC

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1124596382
  Care Compare affiliation

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1558715375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE STE 351",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043830",
            "telephone_number": "909-475-8611",
            "fax_number": "909-475-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE STE 351",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043830",
            "telephone_number": "909-475-8611",
            "fax_number": "909-475-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ILIYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A170915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Godoy DDS Inc
• Andrew Godoy
• Andrew Jacob Godoy
• Rojeania Godsey-Erb
• Godwin Abodoh
• Golden Coast Mso, Inc.
• Golden Medical Services
• Golden Valley Medical & Oxygen Service
• Goldencrest Primary Care
• Amir Hossen Golsorkhi, MD

• Surgery Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.

Verify at the official NPI Registry.