Active NPI
Daniel Goldberg, PA-C
- Physician Assistant
- New Haven, CT
National Provider Identifier
1710590807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5615
- Practice address
- 464 Congress Ave Ste 260
New Haven, CT 06519-1362 - Phone
- (203) 785-4404
- NPI assigned
- Aug 28, 2020
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5615 | CT | Primary |
Addresses
Primary practice location
464 Congress Ave Ste 260
New Haven, CT 06519-1362
Mailing address
7 Beachside CMN
Westport, CT 06880-6243
Other names 1
- Dan Goldberg
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 90.93 of 100
- Quality
- 70.1
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 83.01
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5615 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alaska Native Tribal Health Consortium | Current | Accepting new patients |
Locations
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646870400000",
"number": "1710590807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 BEACHSIDE CMN",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068806243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464 CONGRESS AVE STE 260",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191362",
"telephone_number": "203-785-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "DANIEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-28",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "5615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DAN",
"last_name": "GOLDBERG",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.