Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Etai Goldenberg, MD

Individual provider Urology Physician · NPI 1669663605

Mr. Etai Goldenberg, MD is an Urology in St. Louis, Missouri. Graduated from Wayne State University School of Medicine in 2007, 19 years ago. Practices with Urology of St Louis Inc, a 111-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Missouri.

Years since qualifying
19
Trained at
Wayne State University School of Medicine
Licensed in
IL, MO
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12855 N Forty Dr Ste 375
St. Louis, MO 63141
Phone: (314) 567-6071
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6812 State Route 162 Ste 200, Maryville, IL 62062-8562 — (618) 288-0900

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 2013013914 (MO)
Urology Physician Taxonomy 208800000X · Licence 036133097 (IL)

Record details

NPI number1669663605
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 6, 2007
Last updated in NPPESDecember 1, 2021
Certification dateDecember 1, 2021
Mailing address12855 N. Forty Dr., Ste 375, St. Louis, MO 63141

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2007 (19 years in practice)
Group practice Urology Of St Louis Inc — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in St. Louis