SCOTT ROBERTS GOLDBERG (DDS) – Oral and Maxillofacial Surgery (Dentist), NPI 1457693772

SCOTT ROBERTS GOLDBERG (DDS) is a healthcare provider. based in Boston, Massachusetts. specializing in MAXILLOFACIAL SURGERY. They hold the professional credentials DDS. They hold a License No. DN1857513 (MA). The NPI Number for SCOTT ROBERTS GOLDBERG (DDS) is 1457693772

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
SCOTT ROBERTS GOLDBERG (DDS)
NPI
1457693772
Phone
(617) 414-7558
Address
100 E Newton St
Enumeration Date
25 March 2013
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6088198760
Graduation Year
2013 (13 years ago)
PAC ID
0143451385
Group Practice PAC ID
5294830451
Professional Enrollment ID
I20180606000250
Address ID
WI537172307MA7007XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

66 MAXILLOFACIAL SURGERY in MA

Provider Addresses for SCOTT ROBERTS GOLDBERG (DDS)

  • 100 E Newton St

    G407

    Boston, MA 021182308

    Phone: (617) 414-7558

    Type: Location

  • 810 MAIN ST

    MELROSE, MA 021762711

    Phone: (781) 662-6228

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $1,105.

Total Amount is formed as General ($1,105) + Research ($0) + Ownership ($0) = $1,105.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: DENTSPLY LLC ($600).

Total Amount

$1,105

General + Research + Ownership

Payments

13

Total payment records

General Amount

$1,105

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-06-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180606000250IMaxillofacial SurgeryWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99202New patient office or other outpatient visit, 15-29 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 02118)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294830451View full group profile
NameSpecialtyState
Maxillofacial Surgery, Oral SurgeryWI
Maxillofacial SurgeryWI
Oral SurgeryWI
-WI
Maxillofacial Surgery, Oral SurgeryTX
Oral SurgeryWI

Reviews

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Frequently asked questions

Is there an official ID for SCOTT ROBERTS GOLDBERG (DDS) in U.S. healthcare records?
The official identifier for SCOTT ROBERTS GOLDBERG (DDS) is NPI 1457693772.
Is SCOTT ROBERTS GOLDBERG (DDS) still an active registrant?
SCOTT ROBERTS GOLDBERG (DDS) carries an active NPI according to the public dataset.
How would a patient describe SCOTT ROBERTS GOLDBERG (DDS)'s focus?
For SCOTT ROBERTS GOLDBERG (DDS), the primary taxonomy reads as Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
Is SCOTT ROBERTS GOLDBERG (DDS) located near Boston?
SCOTT ROBERTS GOLDBERG (DDS) currently maps to Boston, Massachusetts in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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