Active NPI
Rachel B Goldberg, MD, MPH
- Psychiatry Physician
- Fairfax, VA
National Provider Identifier
1629395066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101255886
- Practice address
- 3025 Hamaker CT Ste 290
Fairfax, VA 22031-2237 - Phone
- (703) 448-0252
- NPI assigned
- Apr 26, 2010
- Last updated
- Jul 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0101255886 | VA | Primary |
Addresses
Primary practice location
3025 Hamaker CT Ste 290
Fairfax, VA 22031-2237
Mailing address
3025 Hamaker CT Ste 290
Fairfax, VA 22031-2237
Phone (703) 448-0252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 28, 2015 through Aug 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101255886 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1629395066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3025 HAMAKER CT STE 290",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312237",
"telephone_number": "703-448-0252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3025 HAMAKER CT STE 290",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312237",
"telephone_number": "703-448-0252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "RACHEL",
"middle_name": "B",
"credential": "MD, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-26",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101255886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.