Individual provider Active NPI

Jack Goldman, M.D.

  • Internal Medicine Physician
  • Auburn, WA
National Provider Identifier
1023065539
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00017877 Issued in WA
Practice address
101 2ND St NE
Auburn, WA 98002-4902
Phone
(253) 833-3650
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00017877 WA Primary
Specialist 174400000X MD00017877 WA

Addresses

Primary practice location

101 2ND St NE
Auburn, WA 98002-4902

Mailing address

33634 7TH PL SW
Federal Way, WA 98023-5004
Phone (253) 833-3650

Other practice location 1

30809 1st Ave S
Federal Way, WA 98003-4074
Phone (253) 839-2030

Other identifiers 1

IdentifierTypeStateIssuer
1730100MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110106000347 WA Practitioner - Internal Medicine 2769371798 Reassigns benefits to 1 organization
Practice locations: Auburn, WA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Betteridge and McNaughton PS IncGroup PAC ID 7719875814, 2 clinicians

Practice addresses (Care Compare)

3733 S Thompson Ave
Tacoma, WA 98418-5013
Phone (253) 472-4473

803 E Main St
Auburn, WA 98002-5628
Phone (253) 833-3650

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00017877WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Betteridge & McNaughton PS Inc Family Medicine CurrentSince Apr 15, 2025 Accepting new patients
Jack Golman, MD Internal Medicine PastSince May 11, 2011 Accepting new patients

Locations

3733 S Thompson Ave
Tacoma, WA 98418
Phone (206) 472-4473

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jack.goldman@973744416882692.direct.elationemr.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1023065539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33634 7TH PL SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980235004",
            "telephone_number": "253-833-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 2ND ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980024902",
            "telephone_number": "253-833-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30809 1st Ave S",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980034074",
            "country_code": "US",
            "telephone_number": "253-839-2030",
            "fax_number": "253-839-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00017877",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00017877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730100",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.