Mark Goldberg Prosthetic & Orthotic Labs, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MARK GOLDBERG PROSTHETIC & ORTHOTIC LABS, INC.

Practice address

5905 69TH St
Maspeth, NY 11378-2946

Phone

(631) 689-6606

NPI assigned

Jan 10, 2022

Organization subpart

Yes

Parent organization

MARK GOLDBERG PROSTHETIC & ORTHOTIC LABS, INC.As reported in NPPES

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

Authorized official

Name

Joshua Ryan Goldberg

Title

Operations Manage

Phone

(631) 689-6606

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mark Goldberg Prosthetic & Orthotic Labs, Inc.

  • Prosthetic/Orthotic Supplier
  • East Meadow, NY
  • NPI 1437436649

  5991917114

  Same PAC ID
• Mark Goldberg Prosthetic & Orthotic Labs, Inc.

  • Prosthetic/Orthotic Supplier
  • East Setauket, NY
  • NPI 1578742839

  5991917114

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Mark Goldberg Prosthetic Orthotic Labs Inc3 organizations share this tax ID, including this one

Part of

Mark Goldberg Prosthetic Orthotic Labs Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mark Goldberg Prosthetic & Orthotic Labs, Inc.

  • Prosthetic/Orthotic Supplier
  • East Meadow, NY
  • NPI 1437436649
  NPD tax ID
• Mark Goldberg Prosthetic & Orthotic Labs, Inc.

  • Prosthetic/Orthotic Supplier
  • East Setauket, NY
  • NPI 1578742839
  NPD tax ID

Locations

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1891456018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 TECHNOLOGY DR",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334000",
            "telephone_number": "631-689-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 69TH ST",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113782946",
            "telephone_number": "631-689-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK GOLDBERG PROSTHETIC & ORTHOTIC LABS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARK GOLDBERG PROSTHETIC & ORTHOTIC LABS, INC.",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OPERATIONS MANAGE",
        "authorized_official_telephone_number": "631-689-6606"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Maspeth, NY
• Providers in Maspeth, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.