Active NPI
Marisse Goldman, M.D.
- Internal Medicine Physician
- Tampa, FL
National Provider Identifier
1992705313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME53404
- Practice address
- 3304 Westmoreland Dr
Tampa, FL 33618-2156 - Phone
- (813) 690-2003
- Fax
- (813) 264-6929
- NPI assigned
- Jul 28, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME53404 | FL | Primary |
Addresses
Primary practice location
3304 Westmoreland Dr
Tampa, FL 33618-2156
Mailing address
PO Box 341703
Tampa, FL 33694-1703
Phone (813) 690-2003
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040526001015 | FL | Practitioner - Geriatric Medicine | 2860473717 | Practice locations: Tampa, FL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME53404 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398816000000",
"number": "1992705313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 341703",
"city": "TAMPA",
"state": "FL",
"postal_code": "336941703",
"telephone_number": "813-690-2003",
"fax_number": "813-264-6929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3304 WESTMORELAND DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336182156",
"telephone_number": "813-690-2003",
"fax_number": "813-264-6929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "MARISSE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-28",
"last_updated": "2014-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME53404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.