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HOLLY GOLDBERG
NPI 1104680719
Physician Assistant in Charleston, SC

Active since February 13, 2024PECOS Enrolled
171 ASHLEY AVE, CHARLESTON, SC 29425(843) 792-1414 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Holly Goldberg NPPES

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

HOLLY GOLDBERG (NPI 1104680719) is an individual physician assistant in Charleston, South Carolina and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104680719
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameHOLLY GOLDBERG
Location Address171 ASHLEY AVECharleston, SC 29425-4991
Mailing AddressPo Box 751461Charlotte, NC 28275-1461
Phone(843) 792-1414
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 13, 2024
Last NPPES UpdateJuly 25, 2025
NPPES CertifiedJuly 25, 2025
✔ NPI 1104680719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
171 ASHLEY AVE, Charleston, SC 29425
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID6901397298
PECOS Enrollment IDI20251114001078
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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.

CAROLYN REED WORD M.D.
Allergy & Immunology
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
CHRISTOPHER ARNOLD HENSLEY CRNA
Nurse Anesthetist, Certified Registered
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
ANGELINA INDIRA PHILLIPS
Pathology (Anatomic Pathology)
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
BLAKE DANIEL FORCINA
Ophthalmology
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
CHELSEA LEE CRUISE SW
Social Worker
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
DR. RICHARD HAYDEN JONES MD
Radiology (Pediatric Radiology)
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
LINDSEY HENDRICKSON NP
Nurse Practitioner
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
MICHAEL DAMASO DE GUZMAN
Ophthalmology
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414

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 Holly Goldberg's NPI number?

The NPI number for Holly Goldberg is 1104680719. It was assigned to this individual provider in the NPPES registry on February 13, 2024.

Where is Holly Goldberg located?

Holly Goldberg practices at 171 Ashley Ave, Charleston, SC 29425. The listed phone number is (843) 792-1414.

What is Holly Goldberg's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Holly Goldberg enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Holly Goldberg was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.