Ilya G Goldenberg, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

35-081219 Issued in OH

Practice address

2000 Tamarack Rd
Newark, OH 43055-1183

Phone

(614) 297-1158

Fax

(614) 299-3406

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH

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

Internal Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Specialty Hospital - Zanesville IncGroup PAC ID 0042121808, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
• Select Specialty Hospital Southeast Ohio Long-term care hospital, Newark, OH, CCN 362031

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Select Specialty Hospital - Zanesville Inc

  • Hospitalist Physician
  • Newark, OH
  • NPI 1598204398
  Medicare reassignment Care Compare group NPD
• North East Ohio Group Practice LLC

  • Internal Medicine Physician
  • Middleburg Heights, OH
  • NPI 1063575462
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Muskingum County, LTD

  • Internal Medicine Physician
  • Zanesville, OH
  • NPI 1215977608
  NPD (past)
• Select Specialty Hospital - Zanesville Inc

  • Long Term Care Hospital
  • Newark, OH
  • NPI 1861492217
  NPD (past)

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

• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755
  Care Compare affiliation
• Select Specialty Hospital - Zanesville Inc

  • Long Term Care Hospital
  • Newark, OH
  • NPI 1861492217

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1619976669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551183",
            "telephone_number": "614-297-1158",
            "fax_number": "614-299-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551183",
            "telephone_number": "614-297-1158",
            "fax_number": "614-299-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "ILYA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-081219",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35-081219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2378896",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "7600179",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7826564",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000259749",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2097512",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Kay Goates
• Dwight Justin Goddard, MD
• Christine Godenschwager
• Katelyn Goetzman, P.T.A.
• Natasha Golden, LSW
• Rowena Gonzales
• Dale Good
• Deanna Lynne Good
• Heather A Good
• Peter Goodman, MSW, LISW

• Hospitalist Physician in Newark, OH
• Providers in Newark, OH by specialty
• Hospitalist Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.