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JEREMY ADAM GOLDBERG LICSW
NPI 1013243708
Social Worker - Clinical in Minneapolis, MN

Active since October 30, 2009PECOS Enrolled
410 CHURCH ST SE, MINNEAPOLIS, MN 55455(612) 624-1444(612) 677-3211 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 14, 2025, Jul 21, 2022 (2 updates tracked since 2022).

About Jeremy Adam Goldberg Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMY ADAM GOLDBERG LICSW (NPI 1013243708) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (18523) and active in the NPI registry since October 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013243708
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJEREMY ADAM GOLDBERGCredential: LICSW
Location Address410 CHURCH ST SEMinneapolis, MN 55455-0222
Mailing Address410 Church St SeMinneapolis, MN 55455-0222 · (612) 624-1444 · Fax (612) 677-3211
Phone(612) 624-1444
Fax(612) 677-3211
Sole ProprietorNo
Enumeration DateOctober 30, 2009
Last NPPES UpdateNovember 14, 20252 updates tracked since enumeration
NPPES CertifiedNovember 14, 2025
✔ NPI 1013243708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 18523
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
410 CHURCH ST SE, Minneapolis, MN 55455
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeremy Adam Goldberg Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jeremy Goldberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health Specialty Group PA
974 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Minnesota enrollment
  • 98 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55455 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. STEPHANIE GRADY PA & NP
Family Medicine
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2612
RICHARD JON FEIST MD
Family Medicine
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
REGENTS OF THE UNIVERSITY OF MINNESOTA
Clinic/Center (Student Health)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
DR. SABA GHAZIMOGHADAM PH.D.
Psychologist (Counseling)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
JOY L JOHNSON-LIND LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400
MARY KATHERINE UTZ LICSW
Social Worker (Clinical)
410 CHURCH ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-9194
MARILYN SUSAN JOSEPH MD
Obstetrics & Gynecology
410 CHURCH ST SE, BOYNTON HEALTH SERVICE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-5187
DR. GARY ALAN-HUE CHRISTENSON MD
Psychiatry & Neurology (Psychiatry)
410 CHURCH ST SE, BOYNTON HEALTH SERVICE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremy Goldberg's NPI number?

The NPI number for Jeremy Goldberg is 1013243708. It was assigned to this individual provider in the NPPES registry on October 30, 2009.

Where is Jeremy Goldberg located?

Jeremy Goldberg practices at 410 Church St SE, Minneapolis, MN 55455. The listed phone number is (612) 624-1444.

What is Jeremy Goldberg's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jeremy Goldberg enrolled in Medicare?

Yes. Jeremy Goldberg is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeremy Goldberg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeremy Goldberg reassigns Medicare benefits to Mental Health Specialty Group PA (Durham, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeremy Goldberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeremy Goldberg was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.