Daniela Goldenberg, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

54148 Issued in CA

Practice address

710 Lawrence Expy
Suite 286
Santa Clara, CA 95051-5173

Phone

(203) 671-3568

NPI assigned

Dec 1, 2015

Last updated

Feb 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531
  NPD

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1811362981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LAWRENCE EXPY",
            "address_2": "SUITE 286",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LAWRENCE EXPY",
            "address_2": "SUITE 286",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173",
            "telephone_number": "203-671-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "DANIELA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018818",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "54148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Express Wy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pooja Goel, DDS
• Laurie Gohata, R.P.T.
• Golden Century Institute of Medical Tech, Inc.
• Golden Gate Wellness Center
• Golden State Orthopedics & Spine
• Flair D. Goldman, DPM
• Anne Victoria Goldsmith
• Golnoush Golshan, PHARMD
• Kathryn Stansbury Gomes, AMFT
• Alejandra Quetzaly Gomez

• Surgical Physician Assistant in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.

Verify at the official NPI Registry.