Individual provider Active NPI

Samuel Goodman, M.D.

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1134500283
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036146785 Issued in IL
Practice address
3134 N Clark St
Chicago, IL 60657-4414
Phone
(773) 296-5090
Fax
(312) 766-4925
NPI assigned
Jun 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036146785 IL Primary
Internal Medicine Physician 207R00000X 036-146785 IL

Addresses

Primary practice location

3134 N Clark St
Chicago, IL 60657-4414

Mailing address

29373 Network PL
Chicago, IL 60673-3833
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sgoodman301110@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180728000125 IL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Hospitalist 9032403506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Chicago College of Medicine and Surgery, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

900 W Nelson St
Chicago, IL 60657-6704
Phone (773) 296-7089

Hospital & facility affiliations

  • Advocate Hospice Hospice, Oak Brook, IL, CCN 141516
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-146785ILMDInternal Medicine Physician
036146785ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Jul 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 1, 2022 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince Jul 5, 2018 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

3134 N Clark St
Chicago, IL 60657
Phone (312) 766-4949

900 W Nelson St
Chicago, IL 60657
Phone (773) 296-7089

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

29373 Network Pl
Chicago, IL 60673

4025 N Western Ave
Bldg E
Chicago, IL 60618
Phone (773) 275-7700

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.

Hospital & facility affiliations 3

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1134500283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606733833",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574414",
            "telephone_number": "773-296-5090",
            "fax_number": "312-766-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036146785",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-146785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgoodman301110@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.