Individual provider Active NPI

Jeffrey M Goodloe, M.D.

  • Emergency Medicine Physician
  • Tulsa, OK
National Provider Identifier
1285610428
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
K5965 Issued in TX
Practice address
1145 S Utica Ave
6TH Floor - Ou Dept of Emergency Medicine
Tulsa, OK 74104-4000
Phone
(918) 660-3822
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X K5965 TX Primary

Addresses

Primary practice location

1145 S Utica Ave
6TH Floor - Ou Dept of Emergency Medicine
Tulsa, OK 74104-4000

Mailing address

1145 S. Utica Ave, 6TH Floor
University of Oklahoma Department of Emergency Medicine
Tulsa, OK 74104
Phone (918) 660-3822

Other identifiers 3

IdentifierTypeStateIssuer
89933KOtherTXBCBS
930072620OtherTXMEDICARE RAILROAD
118705601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20071105000131 OK Practitioner - Emergency Medicine 9436246683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.83 of 100Reported as group
Quality
81.24
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Green Country Emergency Physicians Group of Tulsa PLLC Emergency Medicine CurrentSince Jul 17, 2011 Accepting new patients
Waterloo Med Co Emergency Medicine PastSince Oct 15, 2010 Accepting new patients
Questcare Medical Services PLLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine Past Accepting new patients
Ahs Hillcrest Medical Center, LLC Past Accepting new patients

Locations

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1285610428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 S. UTICA AVE, 6TH FLOOR",
            "address_2": "UNIVERSITY OF OKLAHOMA DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-660-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 S UTICA AVE",
            "address_2": "6TH FLOOR - OU DEPT OF EMERGENCY MEDICINE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044000",
            "telephone_number": "918-660-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLOE",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K5965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89933K",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "930072620",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118705601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.