Individual provider Active NPI

Stacy Beth Goldbaum, DO

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1760723837
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2018-01440 Issued in NC
Practice address
4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369
Phone
(704) 355-5100
NPI assigned
Mar 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2018-01440 NC
Internal Medicine Physician 207R00000X 2018-01440 NC Primary

Addresses

Primary practice location

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

10650 Park Rd
Ste 330
Charlotte, NC 28210-8538
Phone (704) 302-9462

Other practice location 2

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211-4369
Phone (704) 302-9462

Other practice location 3

1025 Morehead Medical Dr
Ste 500
Charlotte, NC 28204-2963
Phone (704) 446-2320

Other practice location 4

3025 Springbank Ln
Ste 100
Charlotte, NC 28226-3362
Phone (704) 446-2620

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sgoldbaum452783@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20181206000727 NC Practitioner - Internal MedicinePractitioner - Endocrinology 5991005399 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5863
Phone (704) 302-9462

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018-01440NCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Endocrinology, Diabetes & Metabolism CurrentSince Oct 9, 2025 Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Jul 28, 2019 Accepting new patients
Carolinas Medical Center CurrentSince Dec 19, 2018 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Endocrinology, Diabetes & Metabolism CurrentSince Jul 28, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 9, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Dec 19, 2018 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

4525 Cameron Valley Pkwy
Ste 4100
Charlotte, NC 28211
Phone (704) 302-9300

10650 Park Rd
Ste 330
Charlotte, NC 28210
Phone (704) 403-9300

3025 Springbank Ln
Ste 100
Charlotte, NC 28226
Phone (704) 446-2620

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

10650 Park Rd
Ste 420
Charlotte, NC 28210
Phone (704) 302-8700

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1025 Morehead Medical Dr
Ste 500
Charlotte, NC 28204
Phone (704) 355-3149

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

10545 Blair Rd
Ste 200
Mint Hill, NC 28227
Phone (704) 863-9500

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

1550 Faulk St
Monroe, NC 28112
Phone (980) 442-0430

Interoperability endpoints

  • Direct secure messaging: sgoldbaum452783@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1760723837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PKWY",
            "address_2": "STE 4100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114369",
            "telephone_number": "704-355-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 330",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282114369",
            "country_code": "US",
            "telephone_number": "704-302-9462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-446-2320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3025 Springbank Ln",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282263362",
            "country_code": "US",
            "telephone_number": "704-446-2620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBAUM",
        "first_name": "STACY",
        "middle_name": "BETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "2018-01440",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2018-01440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgoldbaum452783@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4525 Cameron Valley Pkwy",
            "address_2": "Ste 4100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282114369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.