Individual provider Active NPI

Jacqueline K Goldberg, PT, DPT

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1750713392
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1233336 Issued in TX
Practice address
8515 Fannin St Ste B
Houston, TX 77054-4811
Phone
(713) 795-0891
Fax
(713) 797-0049
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1233336 TX Primary

Addresses

Primary practice location

8515 Fannin St Ste B
Houston, TX 77054-4811

Mailing address

8455 Fannin St
Suite B
Houston, TX 77054-4803
Phone (713) 795-0891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314000278 TX Practitioner - Physical Therapist in Private Practice 7911203203 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1233336TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Texas Limited Partnership CurrentSince Dec 1, 2015 Accepting new patients
Theraworks Inc Physical Therapist Current Accepting new patients
Theraworks Inc Physical Therapist CurrentSince Feb 16, 2023 Accepting new patients
Select Physical Therapy Texas Limited Partnership Physical Therapist CurrentSince Dec 1, 2015 Accepting new patients

Locations

8455 Fannin St
Ste B
Houston, TX 77054
Phone (713) 398-7447

5514 Atascocita Rd
Humble, TX 77346
Phone (281) 441-5371

605 Rockmead Dr
Ste 200
Kingwood, TX 77339
Phone (281) 348-9588

4899 Highway 6
Ste 212C
Missouri City, TX 77459
Phone (346) 371-2121

8111 Cypresswood Dr
Ste 102
Spring, TX 77379
Phone (281) 376-3900

13440 University Blvd
Ste 210
Sugar Land, TX 77479
Phone (281) 277-1330

711 W Bay Area Blvd
Ste 608
Webster, TX 77598
Phone (281) 338-1273

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.

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1750713392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 FANNIN ST",
            "address_2": "SUITE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770544803",
            "telephone_number": "713-795-0891",
            "fax_number": "713-797-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 FANNIN ST STE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770544811",
            "telephone_number": "713-795-0891",
            "fax_number": "713-797-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1233336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.