Ian J Goldberg, D.O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036074317 Issued in IL

Practice address

1340 Charles St Ste 300
Rockford, IL 61104-2200

Phone

(779) 696-5888

Fax

(779) 696-5898

NPI assigned

Nov 10, 2005

Last updated

Mar 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Cardiovascular Disease (Cardiology)

Education

New York Medical College, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uw Health Hospital, Rockford, IL, CCN 140228
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233

Merit-based Incentive Payment System (MIPS)

Final score

81.51 of 100Reported as group

Quality

83.2

Promoting interoperability

77

Improvement activities

40

Cost

71.7

Merit-based Incentive Payment System (MIPS)

Final score

83.84 of 100Reported as group

Quality

75.22

Promoting interoperability

92

Improvement activities

40

Cost

73.11

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Swedishamerican Hospital

  dba SwedishAmerican Medical Group

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1962451732

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Freeport Memorial Hospital

  dba FHN-Memorial Hospital

  • General Acute Care Hospital
  • Freeport, IL
  • NPI 1447228788
  Medicare reassignment NPD
• Freeport Regional Health Care Foundation

  dba FHN

  • Family Medicine Physician
  • Freeport, IL
  • NPI 1457337016
  Medicare reassignment NPD
• Swedishamerican Hospital

  dba Baptist Pediatric Clinic

  • Pediatrics Physician
  • Rockford, IL
  • NPI 1114470945
  NPD
• Swedishamerican Hospital

  • Community/Retail Pharmacy
  • Rockford, IL
  • NPI 1306635982
  NPD
• Dupage Medical Group LTD

  dba DuPage Medical Group

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  NPD (past)

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

• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation
• Swedishamerican Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1760542732
  Care Compare affiliation

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1871574301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 300",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "779-696-5888",
            "fax_number": "779-696-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "IAN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036074317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "igoldbergdo914031@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1340 Charles St Ste 300",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611042200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Global Dental Center Inc
• Global Imaging Institute
• Cristina Gloria, LCPC
• Cassandra Deann Glover, LCSW
• Elena Clare Godfrey, LSW
• Kaory Gomez-Calzada, DDS
• Rebecca Diane Gomez
• Enrico Gonong, MD
• Edwin Gonzalez Montoya, OMFS
• Alejandro Gonzalez, MS

• Cardiovascular Disease Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.
• 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.