Active NPI
Mark Mitchell Goldberg, D.P.M.
- Podiatrist
- Chestertown, MD
National Provider Identifier
1649240003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 01102
- Practice address
- 970 Washington Ave
Chestertown, MD 21620-3322 - Phone
- (410) 778-1801
- Fax
- (410) 758-3249
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 01102 | MD | Primary |
Addresses
Primary practice location
970 Washington Ave
Chestertown, MD 21620-3322
Mailing address
970 Washington Ave
Chestertown, MD 21620-3322
Phone (410) 778-1801
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01102 | MD | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chester Walk-in Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Chester, MD
- NPI 1598795510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649240003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 WASHINGTON AVE",
"city": "CHESTERTOWN",
"state": "MD",
"postal_code": "216203322",
"telephone_number": "410-778-1801",
"fax_number": "410-758-3249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 WASHINGTON AVE",
"city": "CHESTERTOWN",
"state": "MD",
"postal_code": "216203322",
"telephone_number": "410-778-1801",
"fax_number": "410-758-3249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "MARK",
"middle_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MD",
"license": "01102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chestertown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.