Tracie Goodenberger

Primary specialty

OptometristTaxonomy code 152W00000X

License

1648 Issued in NE

Practice address

3543 S 85TH St Ste 200
Lincoln, NE 68520-1501

Phone

(402) 986-7856

NPI assigned

Jul 12, 2024

Sex

Female

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 NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Daniel Novak OD PCGroup PAC ID 8426466988, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Daniel Novak OD PC

  • Optometrist
  • Lincoln, NE
  • NPI 1235729351
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1124865563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 S 80TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685066508",
            "telephone_number": "785-819-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3543 S 85TH ST STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685201501",
            "telephone_number": "402-986-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODENBERGER",
        "first_name": "TRACIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Life Family Chiropractic LLC
• Good Life Virtual Care
• Jennifer Goodban, LPN
• Kyle Robert Goodban, PT,DPT
• Rebecca Marie Goodban, APRN
• Jamie Marie Goodman Weyant
• Emily Goodman, LIMHP, LMHP, LADC,
• Jessica Goodwin
• Laurie Goodwin
• Mackenzie Goodwin

• Optometrist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.