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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | 43508 | MN | Allopathic & Osteopathic Physicians |
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 |
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 |
Street Address |
1421 PREMIERE DR MANKATO CLINIC@ WICKERSHAM CAMPUS |
City | MANKATO |
State | MN |
Zip Code | 56001-6076 |
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 |
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 |
Find all providers in zip 56001 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
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. |
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 |
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 |
Find all providers with the same taxonomy |
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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.