Individual provider Active NPI

Maria Lana Goldenberg, AU.D.

  • Audiologist
  • Carmel, IN
National Provider Identifier
1790940799
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2007014907 Issued in MO
Practice address
11733 Forest Park LN
Carmel, IN 46033-7223
Phone
(314) 494-4910
NPI assigned
Jul 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2007014907 MO Primary

Addresses

Primary practice location

11733 Forest Park LN
Carmel, IN 46033-7223

Mailing address

7440 N Shadeland Ave
Suite 150
Indianapolis, IN 46250-2029
Phone (317) 570-7353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081208000428 IN Practitioner - Qualified Audiologist 0244391324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

12188 A N Meridian St
Suite 375
Carmel, IN 46032-4433
Phone (317) 926-1056

250 W 96TH St
Suite 520
Indianapolis, IN 46260-1317

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007014907MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Jun 1, 2021 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jun 1, 2021 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

1115 Ronald Reagan Pkwy
Ste 254
Avon, IN 46123
Phone (317) 705-2700

590 Pit Rd
Brownsburg, IN 46112
Phone (317) 415-6040

12188A N Meridian St
Ste 375
Carmel, IN 46032

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

Interoperability endpoints

  • Direct secure messaging: maria.goldenberg.1@7598.direct.athenahealth.com

Organizations & group practices 3

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": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1790940799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 N SHADELAND AVE",
            "address_2": "SUITE 150",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502029",
            "telephone_number": "317-570-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11733 FOREST PARK LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460337223",
            "telephone_number": "314-494-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "MARIA",
        "middle_name": "LANA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-20",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2007014907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.