Individual provider Active NPI

Mark Norman Goodman, MD

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1215148127
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
26188 Issued in OK
Practice address
14813 Hollyhock Dr
Oklahoma City, OK 73142-1829
Phone
(405) 315-1216
NPI assigned
May 24, 2007
Last updated
Aug 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 26188 OK Primary

Addresses

Primary practice location

14813 Hollyhock Dr
Oklahoma City, OK 73142-1829

Mailing address

14813 Hollyhock Dr
Oklahoma City, OK 73142-1829
Phone (405) 315-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20080812000128 OK Practitioner - Anesthesiology 4587765854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Oklahoma College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Anesthesiologists, LLCGroup PAC ID 4688701204, 49 clinicians

Practice addresses (Care Compare)

13321 N Meridian Ave
Oklahoma City, OK 73120-8316
Phone (405) 755-1080

4300 W Memorial Rd
Mercy Health Center Inc
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Anesthesiologists, LLC Anesthesiology CurrentSince Jan 12, 2010 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

13321 N Meridian Ave
Ste 402
Oklahoma City, OK 73120
Phone (405) 755-1080

4200 W Memorial Rd
Ste 703
Oklahoma City, OK 73120
Phone (405) 755-1080

Dept 960431
Oklahoma City, OK 73196

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1215148127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14813 HOLLYHOCK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731421829",
            "telephone_number": "405-315-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14813 HOLLYHOCK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731421829",
            "telephone_number": "405-315-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARK",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "26188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.