Mark S Goldberg, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00206000 Issued in NJ

Practice address

4 Ambler LN
Aberdeen, NJ 07747-1205

Phone

(732) 583-4466

Fax

(732) 583-1639

NPI assigned

Sep 9, 2005

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthdrive Podiatry Group, PC

  • Podiatrist
  • Princeton, NJ
  • NPI 1013106533

  NJ, Podiatrist

  Medicare reassignment NPD
• Healthdrive Podiatry Group, PC

  • Podiatrist
  • Dublin, OH
  • NPI 1689613598
  NPD

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 26, 2007.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1992799464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 AMBLER LN",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077471205",
            "telephone_number": "732-583-4466",
            "fax_number": "732-583-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 AMBLER LN",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077471205",
            "telephone_number": "732-583-4466",
            "fax_number": "732-583-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00206000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5481007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Gammoh
• Natalie Marie Gansas
• Gerald Blumberg P.a.
• Joseph Matthew Gersbeck, PHARMD
• Matthew Joseph Goetz, MS, ATC
• Gratefulhealer, LLC
• Amanda Gregorio, MSED, BCBA
• Dominick Grimaldi, RPH
• Nagy N Guirguis, M.D.
• Christen Lee Guttzeit

• All providers in Aberdeen, NJ
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.