Individual provider Active NPI

Benjamin Goelman, MD

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1811915564
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G39380 Issued in CA
Practice address
14150 Culver Dr
Irvine, CA 92604
Phone
(949) 552-4584
Fax
(949) 551-5612
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G39380 CA Primary

Addresses

Primary practice location

14150 Culver Dr
Irvine, CA 92604

Mailing address

14150 Culver Dr
#100
Irvine, CA 92604
Phone (949) 552-4584

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330000988 CA Practitioner - Family Practice 5395870331

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1811915564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR",
            "address_2": "#100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92604",
            "telephone_number": "949-552-4584",
            "fax_number": "949-551-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92604",
            "telephone_number": "949-552-4584",
            "fax_number": "949-551-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOELMAN",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G39380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.