Mary Bevens Goodman, NP-C

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

NP95003472 Issued in CA

Practice address

450 N Roxbury Dr
Suite #500
Beverly Hills, CA 90210-4231

Phone

(310) 277-2393

NPI assigned

Jan 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Array Skin Therapy a Medical CorporationGroup PAC ID 1557534278, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbevens.goodmannp.p1@direct.plannedparenthoodla.nextgenshare.com

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.

• Array Skin Therapy, a Medical Corporation

  • Dermatology Physician
  • Mission Viejo, CA
  • NPI 1891075123
  Medicare reassignment Care Compare group NPD
• California Heart Associates

  • Specialist
  • Fountain Valley, CA
  • NPI 1659420495
  NPD (past)

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1043677339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N ROXBURY DR",
            "address_2": "SUITE #500",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104231",
            "telephone_number": "310-277-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N ROXBURY DR",
            "address_2": "SUITE #500",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104231",
            "telephone_number": "310-277-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARY",
        "middle_name": "BEVENS",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "NP95003472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jory Frederic Goodman, MD
• Joseph M Goodman, DDS
• Judith L. Goodman, PH.D.
• Lauren Goodman, NP
• Mark P Goodman, M.D.
• Sarah Gordis, LCSW
• Craig David Gordon, MD
• Denise Gordon, PSY.D., M.F.T.
• James Gordon, PH.D., M.F.T.
• Jonathan Melvin Gordon

• Obstetrics & Gynecology Nurse Practitioner in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.