Individual provider Active NPI

Michael Henry Goldbaum, M.D.

  • Ophthalmology Physician
  • La Jolla, CA
National Provider Identifier
1720157142
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C32010 Issued in CA
Practice address
9415 Campus Point Dr
La Jolla, CA 92037-1350
Phone
(858) 534-3516
Fax
(858) 534-7425
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C32010 CA Primary

Addresses

Primary practice location

9415 Campus Point Dr
La Jolla, CA 92037-1350

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other identifiers 2

IdentifierTypeStateIssuer
180016079OtherRAILROAD
00C320100MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929001571 CA Practitioner - Ophthalmology 4587780291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Tulane University School of Medicine, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1911
Phone (858) 249-6753

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C32010CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 1, 1973 Accepting new patients
Regents of the University of California Ophthalmology CurrentSince Jan 1, 1973 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9415 Campus Point Dr
La Jolla, CA 92093
Phone (619) 543-3000

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
#8201
San Diego, CA 92103
Phone (858) 534-6290

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1720157142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 CAMPUS POINT DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371350",
            "telephone_number": "858-534-3516",
            "fax_number": "858-534-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBAUM",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C32010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "180016079",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C320100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.