Individual provider Active NPI

Michael E Goodenberger, MD

  • Dermatology Physician
  • Salem, OR
National Provider Identifier
1205898707
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD16625 Issued in IA
Practice address
2441 Grear St NE
Salem, OR 97301-2749
Phone
(503) 588-0469
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD16625 IA Primary

Addresses

Primary practice location

2441 Grear St NE
Salem, OR 97301-2749

Mailing address

2441 Grear St NE
Salem, OR 97301-2749
Phone (503) 588-0469

Other identifiers 1

IdentifierTypeStateIssuer
013792MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Iowa, RJ & L Carver College of Medicine, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2441 Grear St NE
Salem, OR 97301-2749

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision87
Removal of skin lesions169
Removal of skin cancer326
Removal or shaving of skin growth1-10
Skin biopsy169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16625IAMDDermatology Physician
16625ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205898707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 GREAR ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012749",
            "telephone_number": "503-588-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 GREAR ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012749",
            "telephone_number": "503-588-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODENBERGER",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "MD16625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013792",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.