Active NPI
Jeremy Michael Good, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Portland, OR
National Provider Identifier
1073078366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 202005741NP-PP
- Practice address
- 1225 NE 2ND Ave
Portland, OR 97232-2003 - Phone
- (503) 413-4100
- NPI assigned
- Jan 31, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201809282RN | OR | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202005741NP-PP | OR | Primary |
Addresses
Primary practice location
1225 NE 2ND Ave
Portland, OR 97232-2003
Mailing address
PO Box 8459
Portland, OR 97207-8459
Other practice location 1
847 NE 19th Ave Ste 100
Portland, OR 97232-2684
Phone (503) 238-0769
Other practice location 2
30 NE Mlk Blvd
Portland, OR 97232-2941
Phone (503) 232-1099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Oregon Health Sciences University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1225 NE 2ND Ave
Portland, OR 97232-2003
Phone (503) 944-8000
Hospital & facility affiliations
- Legacy Emanuel Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.62 of 100
- Quality
- 77.21
- Promoting interoperability
- 99.06
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201809282RN | OR | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Telecare Mental Health Services of Oregon, Inc. | Past | Accepting new patients |
Locations
1225 NE 2nd Ave
Portland, OR 97232
Phone (503) 413-5051
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
Networks
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
-
- Clinic/Center
- Portland, OR
- NPI 1700809027
-
- Mental Illness Community Based Residential Treatment Facility
- Portland, OR
- NPI 1124310305
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003367491
-
- Clinical Medical Laboratory
- Portland, OR
- NPI 1295756898
Hospital
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594684800000",
"number": "1073078366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 NE 2ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322003",
"telephone_number": "503-413-4100"
}
],
"practiceLocations": [
{
"address_1": "847 NE 19th Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972322684",
"country_code": "US",
"telephone_number": "503-238-0769",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "30 NE Mlk Blvd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972322941",
"country_code": "US",
"telephone_number": "503-232-1099",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOOD",
"first_name": "JEREMY",
"middle_name": "MICHAEL",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-31",
"last_updated": "2020-07-14",
"certification_date": "2020-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201809282RN",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "202005741NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.