Michael Allen Goedde, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD-21638 Issued in HI

Practice address

120 Keawe St
Hilo, HI 96720-2874

Phone

(808) 437-8200

Fax

(808) 201-9892

NPI assigned

Oct 2, 2009

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1285969659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10243",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967215243",
            "telephone_number": "808-437-8200",
            "fax_number": "808-201-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KEAWE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202874",
            "telephone_number": "808-437-8200",
            "fax_number": "808-201-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDDE",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "HI",
            "license": "61-20399",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0012732",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-21638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Reyes, Psy.D. LLC
• Kimberly Gitzel, L.AC.
• Jennifer Mae Goaring, CNM
• Stephanie Goddard, L.M.T.
• Christopher Godla, D.M.D.
• Going Home Hawaii
• James Blake Goldfarb, MT
• James H Gollop, MD
• Joseph Gomez
• Wanee G Gomez, MD

• Psychiatry Physician in Hilo, HI
• Providers in Hilo, HI by specialty
• Psychiatry Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.