Individual provider

Etai Goldenberg, MD

Urology Physician Medicare enrolled

Etai Goldenberg, MD is an Urology Physician in St. Louis, MO, registered under NPI 1669663605.

Getting there

The practice address on file is 12855 N. FORTY DR. STE 375, St. Louis, MO 63141. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

12855 N. FORTY DR. STE 375, St. Louis, MO 63141 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
2013013914 MO Urology Physician primary
036133097 IL Urology Physician

Licences are recorded in 2 states: MO, IL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Urology
PAC ID
6901055854

Enrolled in Medicare 2 times, across 2 states:

StateEnrollment IDProvider type
Missouri I20130826000292 Practitioner - Urology
Illinois I20131108000881 Practitioner - Urology

Medicare enrolment is recorded as approved under the provider type Practitioner - Urology. There are 2 separate enrolment records across 2 states (MO, IL). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Illinois and Missouri. The practice address on file is in St. Louis, MO, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

IL Illinois
Licence
036133097
Specialty
Urology Physician
Verify with the IL board →
MO Missouri practice address
Licence
2013013914
Specialty
Urology Physician
Verify with the MO board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Urology covers

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. NUCC Health Care Provider Taxonomy, code 208800000X
Allopathic & Osteopathic Physicians Urology

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
208800000X Urology Physician 2013013914 MO primary
208800000X Urology Physician 036133097 IL

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1669663605 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateAug 6, 2007
Last updatedDec 1, 2021
StatusActive
Sole proprietorNo
CredentialMD
Practice address 12855 N. FORTY DR.
STE 375
St. Louis, MO 63141
(314) 567-6071
The last update on file is Dec 1, 2021. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1669663605 passes the NPI check digit test The final digit 5 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 6 6 9 6 6 3 6 0
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 6 3 9 3 6 6 6 0

Sum = 65 · next multiple of 10 = 70 · check digit = 5 · actual last digit = 5

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1669663605?
NPI 1669663605 is the National Provider Identifier assigned to Etai Goldenberg, MD in St. Louis, MO. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Urology Physician cover?
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their…
How do I contact Etai Goldenberg, MD?
The phone number on file with NPPES is (314) 567-6071, last updated Dec 1, 2021. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Etai Goldenberg, MD accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1669663605 a valid number?
Yes. 1669663605 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.