Michael P Goodman, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

C31721 Issued in CA

Practice address

635 Anderson Rd
Suite 12B
Davis, CA 95616-3505

Phone

(530) 753-2787

Fax

(530) 750-0221

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

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 Apr 5, 2016 through Apr 5, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1174558407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD",
            "address_2": "SUITE 12B",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "530-753-2787",
            "fax_number": "530-750-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD",
            "address_2": "SUITE 12B",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "530-753-2787",
            "fax_number": "530-750-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C31721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Aimee Gonzalez, CNM
• Jolie Gonzalez, P.T.
• Samrah Marisol Gonzalez
• Wendy Gonzalez
• Good Neighbor Transport, Inc.
• Lesly Gissel Gopar Chavez
• Ryan N. Gorton, MD
• Roshniben Gosai, B.PHARM.
• Lionel John Gottschalk III, M.D.
• Melissa Noel Grabau, PH.D.

• Specialist in Davis, CA
• Providers in Davis, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.