Eric Goldklang, M.D.
Individual provider Active NPI Emergency Medicine Physician · Lawrenceville, GA
NPI 1659412971 · NPPES record last updated Oct 16, 2023
Key facts
- NPI
- 1659412971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 036108130 (IL)
- Practice address
- 1000 Medical Center Blvd
Lawrenceville, GA 30045-7694 - Phone
- (678) 442-3317
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Medical College of Georgia School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gwinnett Emergency Specialists Observation Services LLC
Cepamerica Illinois LLP
Practice addresses (Care Compare)
1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (954) 939-5000
3620 Howell Ferry Rd
Duluth, GA 30096-3178
Phone (954) 939-5000
7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (773) 774-8000
Hospital & facility affiliations
- Amita Health Resurrection Medical Center
- Northside Hospital Duluth
- Northside Hospital Gwinnett
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.41 of 100
- Quality
- 86.81
- Improvement activities
- 40
- Cost
- 77.34
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040615000272 | GA | Practitioner - Emergency Medicine | 9739163163 | Reassigns benefits to 3 organizations |
| I20231030001763 | IL | Practitioner - Emergency Medicine | 9739163163 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052729 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Northside Emergency Associates, LLC | Emergency Medicine | Current |
Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current |
Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current |
Accepting new patients |
| Gwinnett Emergency Specialists Observation Services, LLC | Emergency Medicine | Current |
Accepting new patients |
| Gwinnett Emergency Specialists, LLC | Emergency Medicine | Current |
Accepting new patients |
| Cherokee Emergency Services, LLC | Past | Accepting new patients | |
| Emergency Professionals Atlanta, PC | Emergency Medicine | Past | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
201 Hospital Rd
Canton, GA 30114
Phone (770) 479-1941
1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356
677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977
1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 052729 | GA | |
| Emergency Medicine Physician | 207P00000X | 036108130 | IL | Yes |
Addresses
Primary practice location
1000 Medical Center Blvd
Lawrenceville, GA 30045-7694
Mailing address
2938 Willowstone Dr
Duluth, GA 30096-4014
Other providers in Lawrenceville, GA
- Ramona J Goetz
- Jennifer Louise Goff
- Amy Goh
- Howard C Goldberg
- Golden Home Care, LLC
- Charya Chhauv by Goldsmith
- Gordon Goldstein
- Lawrence H Goldstein
- Golfvista One LLC
- Andres Eduardo Gomez Vargas
All providers in Lawrenceville, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.