Individual provider Active NPI

Marc Goldman, MD

  • Neurological Surgery Physician
  • St Petersburg, FL
National Provider Identifier
1881811040
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
LP00564 Issued in RI
Practice address
603 7TH St S Ste 500
St Petersburg, FL 33701-4734
Phone
(727) 553-7810
NPI assigned
Apr 19, 2007
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X LP00564 RI Primary

Addresses

Primary practice location

603 7TH St S Ste 500
St Petersburg, FL 33701-4734

Mailing address

603 7TH St S Ste 500
St Petersburg, FL 33701-4734
Phone (727) 553-7810

Other practice location 1

55 Claverick St
Providence, RI 02903-4144
Phone (401) 455-1749

Other identifiers 1

IdentifierTypeStateIssuer
123571500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240716003267 FL Practitioner - Neurosurgery 5698821072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
Suite 500
St Petersburg, FL 33701-4734
Phone (727) 893-6254

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion14
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP00564RIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Jun 1, 2025 Accepting new patients
Neurosurgery Foundation, Inc. Neurological Surgery PastSince Jul 1, 2006 Accepting new patients

Locations

603 7th St S
Ste 100
St Petersburg, FL 33701
Phone (727) 553-7240

603 7th St S
Ste 500
St Petersburg, FL 33701
Phone (727) 822-0442

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1881811040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 500",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014734",
            "telephone_number": "727-553-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 7TH ST S STE 500",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014734",
            "telephone_number": "727-553-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Claverick St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034144",
            "country_code": "US",
            "telephone_number": "401-455-1749",
            "fax_number": "401-455-1292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "RI",
            "license": "LP00564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123571500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.