Aviel Goodman, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

31667 Issued in MN

Practice address

1347 Summit Ave
Saint Paul, MN 55105-2219

Phone

(651) 649-0847

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 22, 2016 through Mar 22, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1114189123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1347 SUMMIT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052219",
            "telephone_number": "651-649-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1347 SUMMIT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052219",
            "telephone_number": "651-649-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "AVIEL",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "31667",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MN",
            "license": "31667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Dianne Good, RDN
• Susan C Goodale, MD
• Elizabeth Diane Goodchild, L.P., L.M.F.T.
• Megan Lynn Goodell
• Molly Goodier, MD
• Meghan Goodman, RD
• Warren T Goodman, MD
• Maxwell Goodmanson
• Goodwill Easter Seals Minnesota
• Jessica Goodwin

• Psychiatry Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.