NPIMap

Individual provider Active NPI

Kalie Marie Goodman, MD

  • Surgery Physician
  • Greenville, SC
National Provider Identifier
1104317999
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
92979 Issued in SC
Practice address
48 Centennial Way
Greenville, SC 29605-4662
Phone
(864) 522-8000
Fax
(864) 522-8005
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 13271767-1205 UT
Surgery Physician 208600000X LL52459 SC
Colon & Rectal Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208C00000X 13271767-1205 UT
Surgery Physician 208600000X 92979 SC Primary

Addresses

Primary practice location

48 Centennial Way
Greenville, SC 29605-4662

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

1250 E 3900 S Ste 320
Salt Lake City, UT 84124-1350
Phone (801) 263-1621

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912001806 SC Practitioner - General Surgery 5890044606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of South Carolina School of Medicine, Greenville, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

48 Centennial Way
Greenville, SC 29605-4627
Phone (864) 522-8005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy43
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92979SCMDSurgery Physician
13271767-1205UTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Single Specialty CurrentSince Sep 30, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 30, 2024 Accepting new patients
Prisma Health-Upstate Single Specialty Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

701 Grove Rd
Fl 3
Greenville, SC 29605
Phone (864) 455-1435

48 Centennial Way
Greenville, SC 29605
Phone (864) 455-1600

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

Interoperability endpoints

  • Direct secure messaging: kgoodman125055@direct.ghs.myhfn.org

Organizations & group practices 3

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 54

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

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1104317999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 CENTENNIAL WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054662",
            "telephone_number": "864-522-8000",
            "fax_number": "864-522-8005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E 3900 S Ste 320",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241350",
            "country_code": "US",
            "telephone_number": "801-263-1621",
            "fax_number": "801-263-1647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "KALIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "13271767-1205",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL52459",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "UT",
            "license": "13271767-1205",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "92979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.