BRADLEY GOLDENBERG MD
NPI 1477595239
Pediatrics - Neonatal-Perinatal Medicine in Gulfport, MS

Q: What is Bradley Goldenberg's NPI number?

The NPI number for Bradley Goldenberg is 1477595239. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Q: What is Bradley Goldenberg's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Active since June 12, 2006PECOS Enrolled

15200 COMMUNITY RD, GULFPORT, MS 39503(228) 575-7022(228) 575-7097 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2023, Feb 23, 2022, Jan 28, 2021 and 3 more (6 updates tracked since 2017).

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About Bradley Goldenberg Md NPPES

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

BRADLEY GOLDENBERG MD (NPI 1477595239) is an individual neonatal-perinatal medicine provider in Gulfport, Mississippi, licensed in Mississippi (28322) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477595239

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameBRADLEY GOLDENBERGCredential: MD

Location Address15200 COMMUNITY RDGulfport, MS 39503-3085

Mailing Address2101 Highway 90Gautier, MS 39553-5340 · (228) 497-7576 · Fax (228) 497-8869

Phone(228) 575-7022

Fax(228) 575-7097

Sole ProprietorNo

Enumeration DateJune 12, 2006

Last NPPES UpdateMarch 7, 20236 updates tracked since enumeration

NPPES CertifiedFebruary 22, 2022

✔ NPI 1477595239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

Licenses✔ Licensed in MS · 28322✔ Licensed in IN · 01070390A✔ Licensed in WI · 674✔ Licensed in LA · 329609✔ Licensed in IL · 036074881

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

15200 COMMUNITY RD, Gulfport, MS 39503

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Other Identifiers 7

Medicaid1J4304MS

Medicaid1L7105MS

Medicaid036074881IL

Other01070390AIN · In State License

Medicaid100098179WI

Other01070390BIN · Csr

Other000001071268IN · Anthem Pin

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Goldenberg Md 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.

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.

TRACY LEIGH LADNER C.F.N.P

Nurse Practitioner (Family)