Active NPI
Carol A. Goldberg, M.D.
- Nephrology Physician
- Englewood, CO
National Provider Identifier
1730265133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 29930
- Practice address
- 730 W. Hampden Ave.
Suite 110
Englewood, CO 80110 - Phone
- (303) 788-4660
- Fax
- (303) 788-4878
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 29930 | CO | Primary |
| Nephrology Registered Nurse | 163WN0300X | 29930 | CO |
Addresses
Primary practice location
730 W. Hampden Ave.
Suite 110
Englewood, CO 80110
Mailing address
730 W. Hampden Ave.
Suite 110
Englewood, CO 80110
Phone (303) 788-4660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01299304 | Medicaid | CO |
Other names 1
- Carol A. Goldberg
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050919000441 | CO | Practitioner - Nephrology | 1153354246 | Practice locations: Englewood, CO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29930 | CO | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas K. Mayeda, M.D., PC | Nephrology | Current | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1730265133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 W. HAMPDEN AVE.",
"address_2": "SUITE 110",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "80110",
"telephone_number": "303-788-4660",
"fax_number": "303-788-4878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 W. HAMPDEN AVE.",
"address_2": "SUITE 110",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "80110",
"telephone_number": "303-788-4660",
"fax_number": "303-788-4878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "CAROL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "CO",
"license": "29930",
"primary": true
},
{
"code": "163WN0300X",
"taxonomy_group": "",
"desc": "Registered Nurse, Nephrology",
"state": "CO",
"license": "29930",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01299304",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROL",
"last_name": "GOLDBERG",
"middle_name": "A.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.