Eli G Goodman, MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

036113160 Issued in IL

Practice address

1600 W Walnut St
Jacksonville, IL 62650-1136

Phone

(217) 479-5890

NPI assigned

Oct 2, 2006

Last updated

Dec 21, 2016By the provider in NPPES

Sex

Male

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 IL

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

Specialty

Internal Medicine

Education

Virginia Commonwealth University, School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Schuyler County Hospital DistrictGroup PAC ID 9638076474, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarah D Culbertson Memorial Hospital Hospital, Rushville, IL, CCN 141333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Schuyler County Hospital District

  • Critical Access Hospital
  • Rushville, IL
  • NPI 1013969112
  Medicare reassignment Care Compare group NPD
• Schuyler County Hospital District

  dba Community Medical Clinic of Table Grove

  • Rural Health Clinic/Center
  • Table Grove, IL
  • NPI 1194223719
  NPD
• Clinica Campesina Family Health Services

  dba Clinica Family Health

  • Clinic/Center
  • Boulder, CO
  • NPI 1184613234
  NPD (past)

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

• Schuyler County Hospital District

  • Critical Access Hospital
  • Rushville, IL
  • NPI 1013969112
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1053405589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-479-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-479-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ELI",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036113160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric A Giebelhausen, MD
• Jordan Amanda Gill, LSW
• Gillespie 694140 (Jacksonville Developmental Center)
• Go Greene Orthopedics LLC
• Golden Moments Senior Care Center LTD
• Robert L. Gordon Jr., M.D.
• Susan Diane Green
• Mark Hindley Greene III, MD
• Jon Gregory, CRNA
• Cathy Grierson

• Geriatric Medicine (Internal Medicine) Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.