Harris Michael Goodman, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G19278 Issued in CA

Practice address

1541 Florida Ave
Ste 200
Modesto, CA 95350-4429

Phone

(209) 577-3388

Fax

(209) 523-0764

NPI assigned

Oct 10, 2005

Last updated

Mar 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• McHenry Medical Group Inc

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1205859154
  Authorized official Same address or phone
• McHenry Medical Group, Inc.

  • Urology Physician
  • Turlock, CA
  • NPI 1649456872
  NPD (past) Authorized official
• McHenry Medical Group, Inc.

  • Urology Physician
  • Manteca, CA
  • NPI 1912183153
  NPD (past) Authorized official

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1215925771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-577-3388",
            "fax_number": "209-523-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "STE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-577-3388",
            "fax_number": "209-523-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "HARRIS",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G19278",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "G19278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN - MEDICARE",
            "identifier": "CD169Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFICATION #",
            "identifier": "ZZZ48224Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020018719",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN- MEDICARE",
            "identifier": "CD069A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Feather Gonzlaez
• Margaret Louise Good, FNP
• Juanita I. Gooden-Johnson, RN
• Adele Hamett Goodeyon, NP
• Dominique Salina Goodman, PA
• Scott Goodreau, M.D.
• Kathleen Marion Goodrich, LCSW
• Macey Goodrich
• Beth Goodridge, RD
• Kim Dale Goodrum, R.N.

• Surgery Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.