Active NPI
Stephen J Goldberg, MD
- Gastroenterology Physician
- Cincinnati, OH
National Provider Identifier
1760488993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 35-0322-15
- Practice address
- 4777 E Galbraith Rd
Cincinnati, OH 45236-2725 - Phone
- (513) 686-5444
- Fax
- (513) 686-5443
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 35-0322-15 | OH | Primary |
Addresses
Primary practice location
4777 E Galbraith Rd
Cincinnati, OH 45236-2725
Mailing address
PO Box 8686
Cincinnati, OH 45208-0686
Phone (513) 686-5444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0243632 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35-0322-15 | OH | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333411200000",
"number": "1760488993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8686",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452080686",
"telephone_number": "513-686-5444",
"fax_number": "513-686-5443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4777 E GALBRAITH RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452362725",
"telephone_number": "513-686-5444",
"fax_number": "513-686-5443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "STEPHEN",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2012-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OH",
"license": "35-0322-15",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0243632",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.