Dimitry B Goufman, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

C52758 Issued in CA

Practice address

302 West Laveta Ave.
Suite 201
Orange, CA 92866

Phone

(714) 835-4404

Fax

(714) 532-6563

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Otolaryngology

Education

Albany Medical College of Union University, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dimitry B. Goufman, MD, Inc.

  • Otolaryngology Physician
  • Orange, CA
  • NPI 1447446125
  Medicare reassignment NPD Authorized official
• Chapman Medical Center Inc

  • Institutional Pharmacy
  • Orange, CA
  • NPI 1053354308
  NPD (past)
• Children'S Hospital of Orange County

  • Children's Hospital
  • Orange, CA
  • NPI 1811080526
  NPD (past)
• Orange County Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1982697678
  NPD (past)
• Robert M Pettis MD Inc.

  • Otolaryngology Physician
  • Laguna Beach, CA
  • NPI 1336287036
  NPD (past)
• St Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1104824101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 WEST LAVETA AVE.",
            "address_2": "SUITE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92866",
            "telephone_number": "714-835-4404",
            "fax_number": "714-532-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 WEST LAVETA AVE.",
            "address_2": "SUITE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92866",
            "telephone_number": "714-835-4404",
            "fax_number": "714-532-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUFMAN",
        "first_name": "DIMITRY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "C52758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Gossett
• Hope Alexandra Gostin
• Bhargavesh Gottam, MD
• Ronald Patrick Goubert
• Asha Goud, M.D.
• Roxanne Gould, DDS
• Marianne Gourd
• Andrea Gourlay, CCC-SLP
• Janhavi Vinayak Govande
• Ruth Govea

• Otolaryngology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.