Individual provider Active NPI

Melanie A Goldberg, CNM

  • Advanced Practice Midwife
  • Albuquerque, NM
National Provider Identifier
1619731668
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
871 Issued in NM
Practice address
4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234
Phone
(505) 727-4500
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X CNM08859 NM
Advanced Practice Midwife 367A00000X 871 NM Primary

Addresses

Primary practice location

4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234

Mailing address

4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234
Phone (505) 727-4500

Other identifiers 1

IdentifierTypeStateIssuer
871OtherNMCNM LICENSE # 871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240228000828 NM Practitioner - Certified Nurse Midwife (CNM) 1951746197 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
CNM08859NMMDObstetrics & Gynecology Physician
871NMMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Feb 1, 2024 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Feb 1, 2024 Accepting new patients
Lovelace Health System, LLC Past Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4705 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87109
Phone (505) 727-4500

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

Interoperability endpoints

  • Direct secure messaging: mgoldberg332962@ahs.direct-ci.com

Organizations & group practices 3

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1619731668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091234",
            "telephone_number": "505-727-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091234",
            "telephone_number": "505-727-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MELANIE",
        "middle_name": "A",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "CNM08859",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNM LICENSE # 871",
            "identifier": "871",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.