Dr Matthew Ethan Goldenberg, PSY D - Medicare Psychologist in Tumwater, WA

Dr Matthew Ethan Goldenberg, PSY D is a medicare enrolled "Psychologist" provider in Tumwater, Washington. His current practice location is 111 Tumwater Blvd Se, Suite 210, Tumwater, Washington. You can reach out to his office (for appointments etc.) via phone at (206) 395-9193.

Dr Matthew Ethan Goldenberg is licensed to practice in Washington (license number PY60416098) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417106675.

Contact Information

Dr Matthew Ethan Goldenberg, PSY D
111 Tumwater Blvd Se, Suite 210,
Tumwater, WA 98501
(206) 395-9193
(360) 464-2720

Map and Direction




Healthcare Provider's Profile

Full NameDr Matthew Ethan Goldenberg
GenderMale
SpecialityPsychologist
Location111 Tumwater Blvd Se, Tumwater, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1417106675
  • Provider Enumeration Date: 09/12/2008
  • Last Update Date: 08/19/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0547488140
  • Enrollment ID: I20140822001879

Medical Identifiers

Medical identifiers for Dr Matthew Ethan Goldenberg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417106675NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist LH6039598 (Washington)Secondary
103T00000XPsychologist PY60416098 (Washington)Primary

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. Dr Matthew Ethan Goldenberg allows following entities to bill medicare on his behalf.
Entity NameSeattle Children's Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003319500
PECOS PAC ID: 9032021050
Enrollment ID: O20031211000532

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. Dr Matthew Ethan 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 AddressPractice Location Address
Dr Matthew Ethan Goldenberg, PSY D
111 Tumwater Blvd Se, Suite 210,
Tumwater, WA 98501

Ph: (206) 395-9193
Dr Matthew Ethan Goldenberg, PSY D
111 Tumwater Blvd Se, Suite 210,
Tumwater, WA 98501

Ph: (206) 395-9193

Reviews and Comments


Psychologist in Tumwater, WA

Mrs. Jennifer Lynn Koch, PSY.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 111 Tumwater Blvd Se Ste C213, Tumwater, WA 98501
Phone: 360-706-2674    Fax: 360-634-3565
Ms. Loreli Thompson, DOCTOR
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 7336 Littlerock Rd Sw, Tumwater, WA 98512
Phone: 360-791-4915    
Carla Van Dam, PHD
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 2620 Rw Johnson Blvd Sw Suite 204, Tumwater, WA 98501
Phone: 360-956-0271    
Dr. Mukti Khanna,
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 205 Clark Pl Se, Tumwater, WA 98501
Phone: 360-352-4177    
Dr. Benjamin Dylan Thomas, PH.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 111 Tumwater Blvd Se Ste C213, Tumwater, WA 98501
Phone: 360-706-2674    

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