Individual provider Active NPI

Robert A Goodman, M.D.

  • Anesthesiology Physician
  • Harrisburg, PA
National Provider Identifier
1104825348
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD424111 Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 782-5118
Fax
(717) 782-5854
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD424111 PA Primary

Addresses

Primary practice location

111 S Front St
Harrisburg, PA 17101-2010

Mailing address

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-5118

Other practice location 1

503 N 21st St
Camp Hill, PA 17011-2204
Phone (717) 763-2126

Other identifiers 1

IdentifierTypeStateIssuer
1009419540003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040628000878 PA Practitioner - Anesthesiology 9931185170 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Pinnacle Anesthesia Services, LLC CurrentSince Feb 1, 2025 Accepting new patients
Riverside Anesthesia Associates, LTD Anesthesiology CurrentSince Jun 1, 2007 Accepting new patients
Upmc Pinnacle Anesthesia Services, LLC Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients
North American Partners in Anesthesia, Pennsylvania , LLC Anesthesiology CurrentSince May 30, 2023 Accepting new patients
West Shore Anesthesia Associates, LTD Anesthesiology Past Accepting new patients

Locations

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

1 Rutherford Rd
Ste 101
Harrisburg, PA 17109
Phone (717) 545-5256

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

Organizations & group practices 5

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1104825348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-5118",
            "fax_number": "717-782-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-5118",
            "fax_number": "717-782-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "503 N 21st St",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170112204",
            "country_code": "US",
            "telephone_number": "717-763-2126",
            "fax_number": "717-975-0779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD424111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009419540003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.