Individual provider Active NPI

David Alan Goddard, PA

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1275032492
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110861 Issued in FL
Practice address
3450 Hull Rd
Gainesville, FL 32607-4144
Phone
(352) 273-7002
Fax
(352) 273-7293
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110861 FL Primary

Addresses

Primary practice location

3450 Hull Rd
Gainesville, FL 32607-4144

Mailing address

1600 SW Archer Rd
Box 112727
Gainesville, FL 32610-3003
Phone (352) 273-7002

Other practice location 1

875 Military Trl Ste 105
Jupiter, FL 33458-5700
Phone (561) 798-6600

Other identifiers 1

IdentifierTypeStateIssuer
100883400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20180410000165 FL Practitioner - Physician Assistant 3173886900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1600 SW Archer
Gainesville, FL 32610-3003

1600 SW Archer Rd
Gainesville, FL 32610-3003

1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535

2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250

2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990

8449 SW Hwy 200
Suite 141
Ocala, FL 34481-9695
Phone (352) 693-3378

PO Box
Suite 1099
Melrose, FL 32666-1099

Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161

Hospital & facility affiliations

  • Uf Health Shands Hospital Hospital, Gainesville, FL, CCN 100113

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110861FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jan 28, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jan 28, 2020 Accepting new patients

Locations

3450 Hull Rd
Gainesville, FL 32607
Phone (352) 273-7002

1600 SW Archer Rd
#112727
Gainesville, FL 32610
Phone (352) 273-7002

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dgoddard450730@direct.shands.ufl.edu

Organizations & group practices 3

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 8

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1275032492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 112727",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-7002",
            "fax_number": "352-273-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 HULL RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074144",
            "telephone_number": "352-273-7002",
            "fax_number": "352-273-7293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Military Trl Ste 105",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334585700",
            "country_code": "US",
            "telephone_number": "561-798-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100883400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.