Elyse Goodman, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

207099 Issued in MA

Practice address

148 Linden St
Suite 208
Wellesley, MA 02482-7900

Phone

(781) 239-0290

Fax

(781) 235-6819

NPI assigned

Apr 6, 2010

Sex

Female

Sole proprietor

No

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

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1225353873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 LINDEN ST",
            "address_2": "SUITE 208",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024827900",
            "telephone_number": "781-239-0290",
            "fax_number": "781-235-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 LINDEN ST",
            "address_2": "SUITE 208",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024827900",
            "telephone_number": "781-239-0290",
            "fax_number": "781-235-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ELYSE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "207099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Gollas, M.D.
• Gabriel Roa Gomez
• Rosangela Gomez
• Goodhaven Health PLLC
• Rashel Goodkin, MD
• Katie Lynn Goodman, MA, LMHC
• Adrienne-Leigh Davis Gordon
• Ida P Gorenburg, M.D.
• Danielle E Gorman
• James R Gorman, M.D.

• Adult Health Nurse Practitioner in Wellesley, MA
• Providers in Wellesley, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.