Bradley Dean Goldberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002961 Issued in MI

Practice address

4363 Highland Rd
Waterford, MI 48328-2141

Phone

(248) 674-4065

Fax

(248) 673-4428

NPI assigned

May 26, 2006

Last updated

Apr 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• B.D.G.Optics, Inc

  • Optometrist
  • Waterford, MI
  • NPI 1033248000
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1740236884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282141",
            "telephone_number": "248-674-4065",
            "fax_number": "248-673-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4363 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282141",
            "telephone_number": "248-674-4065",
            "fax_number": "248-673-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "BRADLEY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI OPTOMETRY LICENSE",
            "identifier": "4901002961",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0F366959901",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Libbie Gleason
• Christine Glowacki, FNP BC
• Daniel Michael Godfrey, RPH
• Jessica Goeth, FNP-BC, MSN
• Paul M. Gold, D.O.
• Jill Meredith Goldberg, OD
• Goldinno Healthcare Corp
• Marilyn Barbara Goldman, M.D.
• Sheldon J Goldstein, DPM
• Sonia Maria Gonzalez

• Optometrist in Waterford, MI
• Providers in Waterford, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.

Verify at the official NPI Registry.