DR. GRIGORY R GOLDBERG MD
NPI 1033142112
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Ocean, NJ
Quality Rating: 45.93 out of 100 score
NPI Status: Active since July 09, 2006
Contact Information
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
Phone: (732) 660-6200
Fax: (732) 660-6201
- Individual
- Male
- Years of Experience 26
- Orthopaedic Surgery
- Orthopaedic Surgery of the Spine
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About GRIGORY GOLDBERG
This page provides the complete NPI Profile along with additional information for Grigory Goldberg, a provider established in Ocean, New Jersey with a medical specialization in Orthopaedic Surgery, focusing in orthopaedic surgery of the spine and more than 26 years of experience. He graduated from State University Of New York Downstate Medical Center in 2000. The healthcare provider is registered in the NPI registry with number 1033142112 assigned on July 2006. The practitioner's primary taxonomy code is 207XS0117X with license number 25MA08514200 (NJ). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1033142112
- Provider Name
- DR. GRIGORY R GOLDBERG MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1200 EAGLE AVE OCEAN, NJ 07712
- Location Phone
- (732) 660-6200
- Location Fax
- (732) 660-6201
- Mailing Address
- 1200 EAGLE AVE OCEAN, NJ 07712
- Mailing Phone
- (732) 660-6200
- Medical School Name
- STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
- Graduation Year
- 2000
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-09-2006
- Last Update Date
- 07-30-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery Orthopaedic Surgery of the Spine
- Taxonomy Code
- 207XS0117X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA08514200
- License State
- NJ
- Taxonomy Description
- Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 39810 (KY) |
| 2 | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 35-089481 (OH) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000000485763 | OTHER (01) | KY | ANTHEM |
| 000000526432 | OTHER (01) | OH | ANTHEM |
| 165869 | OTHER (01) | OH | NATIONWIDE |
Medicare Participation & PECOS Enrollment Status
Grigory Goldberg is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Grigory Goldberg is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3274638614
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090527000402
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Laminectomy or laminotomy (partial removal of spine bones)
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Spinal fusion
X-ray of lower and sacral spine, 2-3 views
X-ray of upper spine, 2-3 views
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 253 times for 195 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 25 times for 24 patientsA laminectomy or laminotomy is a surgical procedure that involves removing part of the bone in your spine, specifically the lamina, to alleviate pressure on your spinal cord or nerves. This can help reduce pain and improve mobility if you're suffering from conditions like herniated discs or spinal stenosis.
This service was performed for 1-10 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 74 times for 74 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 16 times for 16 patientsSpinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.
This service was performed for 1-10 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
This service was performed 117 times for 109 patientsAn X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.
This service was performed 29 times for 29 patientsOverall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 45.93, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 45.93 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 0
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 20
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 44.77
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 44.77
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Documentation of Current Medications in the Medical Record | 100% | 1680 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 95% | 20 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Plan of Care | 11% | 54 |
| Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months | ||
| Falls: Risk Assessment | 30% | 54 |
| Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months | ||
| Health Information Exchange | 8% | 26 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Leveraging a QCDR for use of standard questionnaires | Yes | N/A |
| Participation in a QCDR, demonstrating performance of activities for use of standard questionnaires for assessing improvements in health disparities related to functional health status (e.g., use of Seattle Angina Questionnaire, MD Anderson Symptom Inventory, and/or SF-12/VR-12 functional health status assessment). | ||
| Medication Reconciliation | 96% | 26 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Participation in a QCDR, that promotes use of patient engagement tools. | Yes | N/A |
| Participation in a QCDR, that promotes use of patient engagement tools. | ||
| Participation in CAHPS or other supplemental questionnaire | Yes | N/A |
| Participation in the Consumer Assessment of Healthcare Providers and Systems Survey or other supplemental questionnaire items (e.g., Cultural Competence or Health Information Technology supplemental item sets). | ||
| Patient-Specific Education | 19% | 258 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 44% | 422 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 42% | 737 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 60% | 747 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 22% | 32 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 80% | 329 |
| Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user | ||
| Promote Use of Patient-Reported Outcome Tools | Yes | N/A |
| Demonstrate performance of activities for employing patient-reported outcome (PRO) tools and corresponding collection of PRO data such as the use of PQH-2 or PHQ-9, PROMIS instruments, patient reported Wound-Quality of Life (QoL), patient reported Wound Outcome, and patient reported Nutritional Screening. | ||
| Provide Patient Access | 96% | 258 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 60% | 258 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Use of certified EHR to capture patient reported outcomes | Yes | N/A |
| In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (e.g., home blood pressure, blood glucose logs, food diaries, at-risk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of certified EHR technology, containing this data in a separate queue for clinician recognition and review. | ||
| Use of QCDR for feedback reports that incorporate population health | Yes | N/A |
| Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations. | ||
Reviews for DR. GRIGORY R GOLDBERG MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 3 | 3 | 1 | 4 | 2 | 1 | 1 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 6 | 3 | 2 | 4 | 4 | 1 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 6 + 3 + 2 + 4 + 4 + 1 + 2 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1033142112 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
MR. DAVID ALDEN WHITMAN P.T.
Physical Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
DR. KEVIN CHRISTIAN MCDAID MD
Orthopaedic Surgery
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MRS. THERESE ELIZABETH BAUSENWEIN P.T.
Physical Therapist
1200 EAGLE AVE
SUITE 100
OCEAN, NJ
ZIP 07712
MR. WILLIAM K BAROUTAS P.T.
Physical Therapist
(Orthopedic)
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MRS. SHRUTI V JHAVERI PA-C
Physician Assistant
(Medical)
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MRS. REGINA SARAH MATHEW PT
Physical Therapist
1200 EAGLE AVE
SEAVIEW ORTHOPEDICS AND MEDICAL ASSOCIATES
OCEAN, NJ
ZIP 07712
MELANIE HOBSON RD, CSR
Dietitian, Registered
1200 EAGLE AVE
SEAVIEW PAVILION, SUITE 100
OCEAN, NJ
ZIP 07712
BECKY SELDEN LMT
Massage Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MRS. RALUCA GATCHELL LMT
Massage Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MRS. GIULIA K CHURCH PA
Physician Assistant
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MRS. TORAL S SHAH PT
Physical Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
MS. VARSHA M POHUJA PT
Physical Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
FERHEEN NAQVI
Physical Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
ANTHONY SCHENA PTA
Physical Therapy Assistant
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
DEVARSHIKA P PANDYA PHYSICAL THERAPIST
Physical Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
ROBERT STASIAK DPT
Physical Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
BARBARA MAY LMT
Massage Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
KALI DOUYLLIEZ LMT
Massage Therapist
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
DR. PAUL THOMAS HAYNES II M.D.
Orthopaedic Surgery
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
DR. JOEL PATRICK FECHISIN MD
Orthopaedic Surgery
1200 EAGLE AVE
OCEAN, NJ
ZIP 07712
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033142112, enumerated as an "individual" on July 09, 2006.
The provider is located at 1200 EAGLE AVE OCEAN, NJ 07712 and the phone number is (732) 660-6200.
Orthopaedic Surgery with taxonomy code 207XS0117X and a focus in Orthopaedic Surgery of the Spine.
The provider might be accepting Accepts: Anthem Blue Cross, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
