Individual provider Active NPI

Edward C Goldberg, D.O.

  • Diagnostic Radiology Physician
  • Garden City, MI
National Provider Identifier
1699701433
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101005810 Issued in MI
Practice address
6245 Inkster Rd
Garden City, MI 48135-4001
Phone
(734) 458-3412
Fax
(734) 677-7407
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101005810 MI Primary

Addresses

Primary practice location

6245 Inkster Rd
Garden City, MI 48135-4001

Mailing address

PO Box 1108
Attention: Lynda Thompson
Ann Arbor, MI 48106-1108
Phone (734) 677-7400

Other identifiers 1

IdentifierTypeStateIssuer
4634369MedicaidMI

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
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Medical Imaging, P.C. Diagnostic Radiology PastSince Apr 4, 2017 Accepting new patients
Southfield Radiology Associates, PLLC Diagnostic Radiology Past Accepting new patients
Southfield Radiology Associates PLLC Diagnostic Radiology Past Accepting new patients
DRS Harris Birkhill Wang Songe & Assoc PC Diagnostic Radiology PastSince Jan 1, 2007 Accepting new patients
Prime Garden City Medical Group Diagnostic Radiology Past Accepting new patients
Prime Garden City Medical Group Past Accepting new patients
Southgate X-Ray Nuclear Medicine & Ultrasound, PC Diagnostic Radiology Past Accepting new patients
Oakwood Healthcare Inc Past Accepting new patients

Organizations & group practices 8

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699701433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "address_2": "ATTENTION: LYNDA THOMPSON",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481061108",
            "telephone_number": "734-677-7400",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-3412",
            "fax_number": "734-677-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "EDWARD",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101005810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4634369",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.