Individual provider Active NPI

Michael H Goodman, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Camden, NJ
National Provider Identifier
1093807877
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
MA05933700 Issued in NJ
Practice address
3 Cooper PLZ
Suite 200
Camden, NJ 08103-1438
Phone
(856) 342-2001
Fax
(856) 968-2499
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MA05933700 NJ
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X MA05933700 NJ Primary

Addresses

Primary practice location

3 Cooper PLZ
Suite 200
Camden, NJ 08103-1438

Mailing address

1 Federal St # 200
Camden, NJ 08103-1088
Phone (856) 356-4924

Other identifiers 1

IdentifierTypeStateIssuer
MA05933700OtherNJSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100126000492 NJ Practitioner - Pediatric Medicine 1456340256 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA05933700NJMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cooper Pediatric Specialists, PC CurrentSince Dec 7, 2009 Accepting new patients
Cooper Pediatrics Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

3 Cooper Plz
Rm 309
Camden, NJ 08103
Phone (856) 342-2226

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

110 Marter Ave
Ste 402
Moorestown, NJ 08057
Phone (856) 234-7073

390 N Broadway
Ste 200
Pennsville, NJ 08070
Phone (856) 678-6411

4 Plaza Dr
Ste 401
Sewell, NJ 08080
Phone (856) 270-4050

6400 Main St
Voorhees, NJ 08043
Phone (609) 751-9339

833 Chestnut St
Ste 300
Philadelphia, PA 19107
Phone (215) 861-8800

Interoperability endpoints

  • Direct secure messaging: mgoodman11333@direct.cooperhealth.edu

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cooper University HospitalCamden, NJ, CCN 310014 Hospital Corporate Director Mar 28, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1093807877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2001",
            "fax_number": "856-968-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NJ",
            "license": "MA05933700",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NJ",
            "license": "MA05933700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA05933700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.