Mr Etai Goldenberg, MD is a medicare enrolled "Urology" physician in St. Louis, Missouri. He went to Wayne State University School Of Medicine and graduated in 2007 and has 17 years of diverse experience with area of expertise as Urology. He is a member of the group practice Urology Of St. Louis, Inc, Urology Of St. Louis, Inc and his current practice location is
12855 N. Forty Dr., Ste 375, St. Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 567-6071.
Mr Etai Goldenberg is licensed to practice in Missouri (license number 2013013914) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1669663605.
Physician's Profile
| Full Name | Mr Etai Goldenberg |
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| Gender | Male |
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| Speciality | Urology |
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| Experience | 17 Years |
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| Location | 12855 N. Forty Dr., St. Louis, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Etai Goldenberg attended and graduated from Wayne State University School Of Medicine in 2007
NPI Data:
- NPI Number: 1669663605
- Provider Enumeration Date: 08/06/2007
- Last Update Date: 12/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 6901055854
- Enrollment ID: I20130826000292
Medical Identifiers
Medical identifiers for Mr Etai Goldenberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669663605 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | 036133097 (Illinois) | Secondary |
| 208800000X | Urology | 2013013914 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Urology Of St. Louis, Inc | 6204723786 | 59 |
| Urology Of St. Louis, Inc | 6204723786 | 59 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Etai Goldenberg allows following entities to bill medicare on his behalf.
| Entity Name | Urology Of St. Louis, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528017191
PECOS PAC ID: 6204723786
Enrollment ID: O20050629000005 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Etai Goldenberg is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Etai Goldenberg, MD
12855 N. Forty Dr., Ste 375,
St. Louis, MO 63141
Ph: (314) 567-6071 | Mr Etai Goldenberg, MD
12855 N. Forty Dr., Ste 375,
St. Louis, MO 63141
Ph: (314) 567-6071 |
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