Individual provider Active NPI

Carol A. Goldberg, M.D.

  • Nephrology Physician
  • Englewood, CO
National Provider Identifier
1730265133
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
29930 Issued in CO
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

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01299304MedicaidCO

Other names 1

  • Carol A. Goldberg Professional name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919000441 CO Practitioner - NephrologyPractitioner - Internal Medicine 1153354246 Practice locations: Englewood, CO

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29930COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.