Individual provider Active NPI

Tamara Goodman, M.D.

  • Clinical Neurophysiology Physician
  • Forest Hills, NY
National Provider Identifier
1083094080
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
299984 Issued in NY
Practice address
11247 Queens Blvd Ste 206
Forest Hills, NY 11375-7421
Phone
(718) 544-4200
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 149091 FL
Clinical Neurophysiology Physician 2084N0600X 299984 NY Primary

Addresses

Primary practice location

11247 Queens Blvd Ste 206
Forest Hills, NY 11375-7421

Mailing address

11247 Queens Blvd Ste 206
Forest Hills, NY 11375-7421

Other practice location 1

139 N Central Ave Ste 2
Valley Stream, NY 11580-3859
Phone (516) 887-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210618000933 NY Practitioner - Neurology 1153668660 Reassigns benefits to 2 organizations
I20210702000844 FL Practitioner - Neurology 1153668660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Neurological Care PCGroup PAC ID 9537320593, 14 clinicians
SJ All Medical PCGroup PAC ID 9830412642, 10 clinicians
Comprehensive Neurological Care PAGroup PAC ID 0446651210, 6 clinicians

Practice addresses (Care Compare)

112 47 Queens Boulevard
Suite 206
Forest Hills, NY 11375-7421
Phone (718) 544-4200

139 N Central Ave
Suite 2
Valley Stream, NY 11580-3859
Phone (516) 887-8808

18975 Collins Ave
Unit 1602
Sunny Isl BCH, FL 33160-2357
Phone (800) 200-8196

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149091FLMDClinical Neurophysiology Physician
299984NYMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Neurological Care PA CurrentSince Jun 30, 2021 Accepting new patients
South Florida Neurology Center PA Current Accepting new patients
SJ All Medical PC Clinical Neurophysiology CurrentSince Apr 1, 2021 Accepting new patients
Complete Neurological Care PC CurrentSince Apr 1, 2021 Accepting new patients

Locations

7050 W Palmetto Park Rd
Ste 15175
Boca Raton, FL 33433

7301 W Palmetto Park Rd
Ste 103C
Boca Raton, FL 33433
Phone (561) 395-2667

7730 W Boynton Beach Blvd
Ste 4
Boynton Beach, FL 33437
Phone (561) 572-0299

8130 Royal Palm Blvd
Ste 201
Coral Springs, FL 33065
Phone (954) 421-3200

11247 Queens Blvd
Ste 206
Forest Hills, NY 11375
Phone (718) 268-1750

225 Broadway
Ste 705
New York, NY 10007
Phone (212) 349-2787

150 E 55th St
Fl 4
New York, NY 10022
Phone (212) 349-2787

139 N Central Ave
Ste 2
Valley Stream, NY 11580
Phone (516) 887-8808

125 N Central Ave
Ste A
Valley Stream, NY 11580
Phone (516) 887-8808

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1083094080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11247 QUEENS BLVD STE 206",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11247 QUEENS BLVD STE 206",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757421",
            "telephone_number": "718-544-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 N Central Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115803859",
            "country_code": "US",
            "telephone_number": "516-887-8808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "149091",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "299984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.