Individual provider Active NPI

Martin Halmes Goodenberger, M.D.

  • Diagnostic Radiology Physician
  • Omaha, NE
National Provider Identifier
1245525112
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
29030 Issued in NE
Practice address
Emile 42ND St
Omaha, NE 68198-1045
Phone
(402) 559-1010
Fax
(402) 559-1011
NPI assigned
Jun 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 6499 NE
Diagnostic Radiology Physician 2085R0202X 29030 NE Primary

Addresses

Primary practice location

Emile 42ND St
Omaha, NE 68198-1045

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Other identifiers 1

IdentifierTypeStateIssuer
29030OtherNESTATE OF NE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20170616001979 NE Practitioner - Diagnostic Radiology 1557593852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29030NEMDDiagnostic Radiology Physician
6499NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Jul 17, 2017 Accepting new patients
Nebraska Health Imaging LLC Diagnostic Radiology CurrentSince Jun 28, 2017 Accepting new patients

Locations

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

987400 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-3405

7819 Dodge St
Omaha, NE 68114
Phone (402) 384-8882

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1245525112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMILE 42ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981045",
            "telephone_number": "402-559-1010",
            "fax_number": "402-559-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODENBERGER",
        "first_name": "MARTIN",
        "middle_name": "HALMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-18",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "6499",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "29030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NE MEDICAL LICENSE",
            "identifier": "29030",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.