NPIMap

Individual provider Active NPI

Scott T Goodrich, M.D.

  • Gynecologic Oncology Physician
  • Fort Wayne, IN
National Provider Identifier
1083748966
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
01078092A Issued in IN
Practice address
2514 E Dupont Rd Ste 100
Fort Wayne, IN 46825-1619
Phone
(260) 484-8830
Fax
(260) 483-1911
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01078092A IN
Gynecologic Oncology Physician 207VX0201X 01078092A IN Primary

Addresses

Primary practice location

2514 E Dupont Rd Ste 100
Fort Wayne, IN 46825-1619

Mailing address

PO Box 749495
Atlanta, GA 30374-9495
Phone (855) 963-2100

Other practice location 1

315 W Old Key Dr Ste 140
Peru, IN 46970-9058
Phone (260) 436-0800

Other practice location 2

1100 Mercer Ave
Decatur, IN 46733-2303
Phone (260) 436-0800

Other practice location 3

737 N Detroit St
Warsaw, IN 46580-2985
Phone (260) 436-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170516000848 IN Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 6002082302 Reassigns benefits to 2 organizations
I20240517002130 SD Practitioner - Gynecological Oncology 6002082302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
University of Vermont College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Oncology Partners PAGroup PAC ID 0042569758, 377 clinicians

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

737 N Detroit St
Warsaw, IN 46580-2985
Phone (260) 436-0800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Skin biopsy1-10
Removal of the uterus24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc. CurrentSince Mar 23, 2024 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Mar 23, 2024 Accepting new patients
American Oncology Partners PA Gynecologic Oncology CurrentSince Nov 11, 2024 Accepting new patients
Community Physicians of Indiana Inc Obstetrics & Gynecology CurrentSince May 28, 2021 Accepting new patients
Community Physicians of Indiana Inc CurrentSince May 28, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1100 Mercer Ave
Decatur, IN 46733

2514 E DuPont Rd
Ste 100
Fort Wayne, IN 46825
Phone (604) 848-8302

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

8550 Naab Rd
Ste 205
Indianapolis, IN 46260
Phone (317) 338-6040

1400 N Ritter Ave
Ste 241
Indianapolis, IN 46219
Phone (317) 621-1690

7979 N Shadeland Ave
Ste 310
Indianapolis, IN 46250
Phone (317) 621-3780

2505 N Lebanon St
Ste 125
Lebanon, IN 46052
Phone (765) 483-7333

1025 Michigan Ave
Logansport, IN 46947
Phone (574) 753-9000

737 N Detroit St
Warsaw, IN 46580
Phone (260) 436-0259

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Organizations & group practices 7

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1083748966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749495",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749495",
            "telephone_number": "855-963-2100",
            "fax_number": "239-236-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 E DUPONT RD STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251619",
            "telephone_number": "260-484-8830",
            "fax_number": "260-483-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Old Key Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IN",
            "postal_code": "469709058",
            "country_code": "US",
            "telephone_number": "260-436-0800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Mercer Ave",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IN",
            "postal_code": "467332303",
            "country_code": "US",
            "telephone_number": "260-436-0800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "737 N Detroit St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465802985",
            "country_code": "US",
            "telephone_number": "260-436-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "SCOTT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01078092A",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IN",
            "license": "01078092A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.