Wendy Monique Goodrich, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1297 Issued in ID

Practice address

623 S Main St Ste 1
Moscow, ID 83843-2983

Phone

(208) 882-2011

Fax

(208) 883-1853

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gritman Medical Center IncGroup PAC ID 0941545784, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gritman Medical Center Hospital, Moscow, ID, CCN 131327
• Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wgoodrich691690@direct.ochin.org

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.

• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Moscow, ID
  • NPI 1538634522
  Medicare reassignment Care Compare group
• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Medicare reassignment
• Gritman Medical Center Inc.

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590
  NPD
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Lewiston, ID
  • NPI 1588413694
  NPD
• Physical Medicine and Rehabilitation Associates of El Paso, P.a.

  • Physical Medicine & Rehabilitation Physician
  • El Paso, TX
  • NPI 1306867890
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144
  Care Compare affiliation
• Gritman Medical Center Inc.

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590

  Hospital

  Care Compare affiliation
• Public Hospital District #1-a of Whitman County

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Care Compare affiliation

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1255400388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 S MAIN ST STE 1",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433042",
            "telephone_number": "208-882-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S MAIN ST STE 1",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432983",
            "telephone_number": "208-882-2011",
            "fax_number": "208-883-1853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 K St NW",
            "address_2": "Suite 512",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061003",
            "country_code": "US",
            "telephone_number": "202-293-3636",
            "fax_number": "202-293-0289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2021 K St NW",
            "address_2": "Suite 512",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061003",
            "country_code": "US",
            "telephone_number": "202-293-3636",
            "fax_number": "202-293-0289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 W A St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "83843",
            "country_code": "US",
            "telephone_number": "208-882-0540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "WENDY",
        "middle_name": "MONIQUE",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5747",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1297",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "PA030391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaye Marie Girard, RPH
• Stuart Charles Goldstein
• Oswaldo Gomez
• Orlando Gonzalez Gomar
• Rebecca Marie Goodrich, LMP, NCTMB
• Michelle Lynn Gorton, CST
• Melodie Grady, PHARMD
• Lorraine Windridge Granfield, CRNA
• Philip Allan Gray
• Brookeanne Gregory

• Physician Assistant in Moscow, ID
• Providers in Moscow, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.