Individual provider Active NPI

Michael D Good, MD

  • Family Medicine Physician
  • Middletown, CT
National Provider Identifier
1104936905
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
026487 Issued in CT
Practice address
400 Saybrook Rd
Suite 205
Middletown, CT 06457-4773
Phone
(860) 346-7738
Fax
(860) 347-2097
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 026487 CT Primary

Addresses

Primary practice location

400 Saybrook Rd
Suite 205
Middletown, CT 06457-4773

Mailing address

4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20040109000019 CT Practitioner - Family Practice 5092615955 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026487CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital Family Medicine CurrentSince Jul 19, 2013 Accepting new patients
Middlesex Hospital Family Medicine CurrentSince Jul 19, 2013 Accepting new patients
Prohealth Physicians PC Family Medicine CurrentSince Jun 1, 1997 Accepting new patients
Prohealth Physicians, Inc. Family Medicine Past Accepting new patients

Locations

42 E High St
East Hampton, CT 06424
Phone (860) 344-6394

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

4 Farm Springs Rd
Farmington, CT 06032
Phone (860) 284-5200

90 S Main St
Middletown, CT 06457
Phone (860) 358-6300

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

400 Saybrook Rd
Ste 205
Middletown, CT 06457
Phone (860) 346-7738

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: michael.good.npi1104936905.phpct@direct.optumcare.masshiway.net

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104936905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "address_2": "PROHEALTH PHYSICIANS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SAYBROOK RD",
            "address_2": "SUITE 205",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574773",
            "telephone_number": "860-346-7738",
            "fax_number": "860-347-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "026487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.