Jay Maury Goodman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD09880 Issued in OR

Practice address

3024 SE Woodstock Blvd
Portland, OR 97202-8136

Phone

(541) 260-2399

NPI assigned

May 7, 2021

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

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": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1205410065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82234",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820234",
            "telephone_number": "541-260-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 SE WOODSTOCK BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972028136",
            "telephone_number": "541-260-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JAY",
        "middle_name": "MAURY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD09880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Thomas Goodlin, DMD
• Molly Goodling
• Rory Goodman-Farley
• Carly L Goodman
• Crystal Goodman
• Jerome M Goodman
• Jillian Louise Goodman, MS
• Karen Goodman
• Kelly L Goodman, MSW
• Kristina Marie Goodman, QMHP

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.