Individual provider Active NPI

Reid A Goodman, MD

  • Obstetrics & Gynecology Physician
  • Denver, CO
National Provider Identifier
1093728305
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20594 Issued in CO
Practice address
425 S. Cherry Street
Suite 300
Denver, CO 80246-1230
Phone
(303) 388-4631
Fax
(303) 320-6961
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20594 CO Primary

Addresses

Primary practice location

425 S. Cherry Street
Suite 300
Denver, CO 80246-1230

Mailing address

425 S. Cherry Street
Suite 300
Denver, CO 80246-1230
Phone (303) 388-4631

Other identifiers 1

IdentifierTypeStateIssuer
01205947MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20101110001084 CO Practitioner - Obstetrics/Gynecology 1153424783

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20594COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Kidney Associates, PC Past Accepting new patients

Organizations & group practices 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1093728305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S. CHERRY STREET",
            "address_2": "SUITE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461230",
            "telephone_number": "303-388-4631",
            "fax_number": "303-320-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S. CHERRY STREET",
            "address_2": "SUITE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461230",
            "telephone_number": "303-388-4631",
            "fax_number": "303-320-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "REID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "20594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01205947",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.