Active NPI
Scott Goldberg
- Student in an Organized Health Care Education/Training Program
- Chicago, IL
National Provider Identifier
1801258504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1656 S Throop St Apt 2R
Chicago, IL 60608-2136 - Phone
- (732) 539-3733
- NPI assigned
- Mar 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1656 S Throop St Apt 2R
Chicago, IL 60608-2136
Mailing address
1656 S Throop St Apt 2R
Chicago, IL 60608-2136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Mount Vernon Hospital | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
305 E 161st St
Bronx, NY 10451
Phone (718) 410-4711
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- sgoldberg3681329@nychhc.direct-ci.com
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.
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- General Acute Care Hospital
- Mount Vernon, NY
- NPI 1013345065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458604800000",
"number": "1801258504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1656 S THROOP ST APT 2R",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606082136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1656 S THROOP ST APT 2R",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606082136",
"telephone_number": "732-539-3733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "SCOTT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-22",
"last_updated": "2016-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.