GARY S GOLDBERG


Address: 1421 Premiere Dr, Mankato Clinic@ Wickersham Campus, Mankato, MN 56001-6076
Phone: 5076251811

GARY S GOLDBERG (NPI# 1013995034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013995034
Entity Type Individual
Full Name GARY S GOLDBERG
Credential MD
Practice Address 1421 Premiere Dr
Mankato Clinic@ Wickersham Campus
Mankato
MN 56001-6076
Mailing Address Po Box 8674
1230 E Main St Mankato Clinic Ltd
Mankato
MN 56002-8674
Practice Telephone 5076251811
Enumeration Date 2006-01-09
Last Update Date 2020-07-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208800000X Urology 43508 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MN HEALTH PARTNERS HP34028 01
MN BCBS 47D36GO 01
RR MEDICARE 340019399 01
MN 392183200 05
MN AMERICAS PPO 1808800 01
MN PREFFERED ONE NA2951028013 01
IA MEDICAID 0568394 01
MN UCARE 140754 01
MN MEDICA 1900310 01

Other Providers GARY GOLDBERG

NPI Name Taxonomy Address Enumeration
1255997714 Gary Jeffrey Goldberg Social Worker 900 Route 168 Ste D1, Turnersville, NJ 08012-3207 2019-05-10
1326128885 Gary L Goldberg Obstetrics & Gynecology Institute for Women's Health, 1695 Eastchester Road, Bronx, NY 10461 2006-10-17
1497835342 Gary J. Goldberg Emergency Medicine 3100 N Tenaya Way, Las Vegas, NV 89128-0436 2006-10-16
1659472876 Gary H. Goldberg Emergency Medicine 407 Uluniu St, 4th Floor, Kailua, HI 96734-2519 2006-09-26
1649291105 Gary L Goldberg Psychologist 200 S Orange Ave, Livingston, NJ 07039-5817 2006-07-21
1306864269 Gary Ira Goldberg Chiropractor 10420 Queens Blvd, Suite 1w, Forest Hills, NY 11375-3629 2006-07-18
1033181334 Gary Stuart Goldberg Anesthesiology 1850 N Central Ave, Ste 1600, Phoenix, AZ 85004-4633 2006-02-02
1790764736 Gary D Goldberg Urology 535 Plandome Rd, Manhasset, NY 11030-1961 2006-01-10
1235137258 Gary Goldberg Physical Medicine & Rehabilitation 1350 Locust St, Suite 409, Pittsburgh, PA 15219-4738 2005-07-13

Office Location

Street Address 1421 PREMIERE DR
MANKATO CLINIC@ WICKERSHAM CAMPUS
City MANKATO
State MN
Zip Code 56001-6076

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205816287 John W Benson Family Medicine 1421 Premiere Dr, Mankato Clinic At Wickersham, Mankato, MN 56001-6076 2006-01-18
1215916218 Michael C James Urology 1421 Premiere Dr, Mankato Clinic At Wickersham Campus, Mankato, MN 56001-6076 2006-01-10
1124006143 Lynn K Gustafson Podiatrist 1421 Premiere Dr, Mankato Clinic @ Wickersham Campus, Mankato, MN 56001 2006-01-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154935435 Kelly Nicole Ricke Physical Medicine & Rehabilitation 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 2020-09-03
1649816786 Ashley Lynn Walters Technician, Other 501 Madison Ave., Mankato, MN 56001 2019-11-25
1720631716 Dovetail Traslation LLC Interpreter 212 Dublin Ct, Same As Above, Mankato, MN 56001 2019-07-19
1093377871 Lindsey Keithahn Counselor 2100 Bassett Drive, Mankato, MN 56001 2019-07-02
1255803813 Amy Marie Williams Acupuncturist 709 S. Front Street, Suite 5, Mankato, MN 56001 2018-12-20
1518437573 Ashley Blanchard Acupuncturist Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 2018-12-03
1831687235 Christian Goetz Specialist/Technologist 401-477 South Rd, Mankato, MN 56001 2018-05-01
1366949141 Minnesota State College and Universities Specialist/Technologist 135 Myers Field House, Mankato, MN 56001 2018-04-09
1780191775 Kevin David Nelson Pharmacist 111 Redtail Ct Apt 308, Mankato, MN 56001 2017-12-29
1972014231 Rylee Wagner Speech-Language Pathologist Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 2017-10-13
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Taxonomy Information

Taxonomy Code 208800000X
Grouping Allopathic & Osteopathic Physicians
Classification Urology

Taxonomy Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629485214 Derek Gearman Urology 1025 Marsh St, Mankato, MN 56001-4752 2014-07-16
1982807350 Kenneth M Smith Urology 1025 Marsh St, Mankato, MN 56001-4752 2007-06-06
1386724102 Joe Y Lee Urology 1025 Marsh St, Mankato, MN 56001 2006-10-16
1215916218 Michael C James Urology 1421 Premiere Dr, Mankato Clinic At Wickersham Campus, Mankato, MN 56001-6076 2006-01-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255939286 Joseph Marconni Sewell Araya Urology 11920 Baypoint Dr, Burnsville, MN 55337-3367 2020-10-12
1922599737 Subodh Kumar Regmi Urology Department of Urology, University of Minnesoata, 420 Delaware St S.e., Mmc 394, Minneapolis, MN 55455 2018-05-29
1700281953 Centracare Clinic Urology 2351 Connecticut Ave S, Suite 200, Centracare Clinic- Adult & Pediatric Urology, Sartell, MN 56377-2477 2014-10-30
1154734127 Abhinav Khanna Urology 200 First Street Nw, Rochester, MN 55905-0001 2014-06-08
1427476662 Khushabu Kasabwala Urology 420 Delaware St. S. E., Mmc 394, Minneapolis, MN 55455 2014-04-04
1518302181 Daniel Liberman Urology 420 Delaware Stre Se, Suite B435, Institute for Prostrate and Urologic Cancers, Minneapolis, MN 55455-0341 2013-05-08
1386981637 Urology Associates, Ltd. Urology 244 7th Street North, Mora, MN 55051 2013-01-07
1831445691 Urology Associates, Ltd. Urology 111 Hundertmark Rd Ste 410, 212 Medical Building, Chaska, MN 55318-1458 2012-07-31
1841590593 Hakim Medical Enterprises, P.a. Urology 2963 Fairchild Ave, Wayzata, MN 55391-2956 2010-10-28
1164747085 Joseph Robert Nelson Zabell Urology 6363 France Ave S Ste 500, Edina, MN 55435-2135 2010-04-03
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Competitor

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City MANKATO
Zip Code 56001

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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