ELLEN GOLDBERG - NPI 1063115624 - Student in an Organized Health Care Education/Training Program in Chicago, IL

Q: What is Ellen Goldberg's NPI number?

The NPI number for Ellen Goldberg is 1063115624. It was assigned to this individual provider in the NPPES registry on March 23, 2023.

Q: What is Ellen Goldberg's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Ellen Goldberg was last updated on March 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Ellen Goldberg NPPES

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

ELLEN GOLDBERG (NPI 1063115624) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1063115624

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameELLEN GOLDBERG

Location Address924 E 57TH ST STE 104Chicago, IL 60637-1455

Mailing Address924 E 57th St Ste 104Chicago, IL 60637-1455 · (773) 702-1939

Phone(773) 702-1939

Sole ProprietorYes

Enumeration DateMarch 23, 2023

NPPES CertifiedMarch 23, 2023

✔ NPI 1063115624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

924 E 57TH ST STE 104, Chicago, IL 60637

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Secondary Practice Location 1

Location 1924 E 57th St Ste 104Chicago, IL 60637-1455

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellen Goldberg 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.