Individual provider Active NPI

Aaron Goodenough

  • Physician Assistant
  • Ventura, CA
National Provider Identifier
1003101494
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21638 Issued in CA
Practice address
100 N Brent St Ste 201
Ventura, CA 93003-2835
Phone
(805) 643-3330
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21638 CA Primary

Addresses

Primary practice location

100 N Brent St Ste 201
Ventura, CA 93003-2835

Mailing address

100 N Brent St Ste 201
Ventura, CA 93003-2835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111010000556 CA Practitioner - Physician Assistant 6305018698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.74 of 100Reported as group
Quality
78.57
Improvement activities
40
Cost
79.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
21638CAMDSpeech-Language Pathologist
PA21638CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jun 23, 2012 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1003101494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BRENT ST STE 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BRENT ST STE 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032835",
            "telephone_number": "805-643-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODENOUGH",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.