Individual provider Active NPI

Jason Edward Goodman, M.D,

  • Obstetrics & Gynecology Physician
  • Elizabethtown, KY
National Provider Identifier
1114199189
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R1967 Issued in KY
Practice address
1115 Woodland Dr
Elizabethtown, KY 42701-2749
Phone
(270) 769-5963
Fax
(270) 769-9051
NPI assigned
Mar 29, 2008
Last updated
Jun 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R1967 KY Primary

Addresses

Primary practice location

1115 Woodland Dr
Elizabethtown, KY 42701-2749

Mailing address

1115 Woodland Dr
Elizabethtown, KY 42701-2749
Phone (270) 769-5963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20120717000243 KY Practitioner - Obstetrics/Gynecology 5799941969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Louisville School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1115 Woodland Dr
Elizabethtown, KY 42701-2749
Phone (270) 769-5963

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1967KYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Obstetrics & Gynecology CurrentSince Jul 1, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2021 Accepting new patients
Baptist Healthcare System Inc Past Accepting new patients

Locations

1115 Woodland Dr
Elizabethtown, KY 42701
Phone (270) 769-5963

551 Westport Rd
Ste D
Elizabethtown, KY 42701
Phone (270) 765-3301

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1206748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1114199189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WOODLAND DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012749",
            "telephone_number": "270-769-5963",
            "fax_number": "270-769-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 WOODLAND DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012749",
            "telephone_number": "270-769-5963",
            "fax_number": "270-769-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-29",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KY",
            "license": "R1967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.