Individual provider Active NPI

Marshall J Golden, MD

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1750358008
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
15601 Issued in NV
Practice address
2020 Palomino LN Ste 100
Las Vegas, NV 89106-4894
Phone
(702) 759-8600
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 15601 NV Primary
Diagnostic Radiology Physician 2085R0202X 20277 MN

Addresses

Primary practice location

2020 Palomino LN Ste 100
Las Vegas, NV 89106-4894

Mailing address

11553 Snow Creek Ave
Las Vegas, NV 89135-1669
Phone (952) 212-1314

Other practice location 1

5775 Wayzata Boulevard
Suite 190
St Louis Park, MN 55416
Phone (952) 541-1840

Other practice location 2

11553 Snow Creek Ave
Las Vegas, NV 89135-1669
Phone (952) 212-1314

Other identifiers 1

IdentifierTypeStateIssuer
125290900MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20277MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology Past 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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1750358008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11553 SNOW CREEK AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351669",
            "telephone_number": "952-212-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 PALOMINO LN STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064894",
            "telephone_number": "702-759-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5775 Wayzata Boulevard",
            "address_2": "Suite 190",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "55416",
            "country_code": "US",
            "telephone_number": "952-541-1840",
            "fax_number": "952-513-6880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11553 Snow Creek Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891351669",
            "country_code": "US",
            "telephone_number": "952-212-1314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "MARSHALL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "15601",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "20277",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125290900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.