Agnessa Gadeliya Goodson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

DR.0054255 Issued in CO

Practice address

6240 S Main St
Aurora, CO 80016-5376

Phone

(303) 908-1673

NPI assigned

Apr 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Dermatology

Education

University of Colorado School of Medicine, Denver, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Dermatology PLLCGroup PAC ID 1254726078, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agoodson@premierdermpllc.emadirect.md

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.

• Premier Dermatology, PLLC

  • Dermatology Physician
  • Aurora, CO
  • NPI 1023787371
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1295025682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7867 S CATHAY ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800161941",
            "telephone_number": "303-908-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 S MAIN ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165376",
            "telephone_number": "303-908-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "AGNESSA",
        "middle_name": "GADELIYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0054255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua I Goodman, DMD
• Karyn A Goodman, M.D.
• Marc Paul Goodman, M.D.
• Laura Beth Goodrich, RN
• Cydney Goodrum
• Joseph R Googins
• Tiffany Ann Goolsby, PHARMD
• Blair Kevin Gordon, M.D.
• Diane Jean Wood Gordon, MD
• Elizabeth Marie Gordon, MSW, LCSW, CCM

• Dermatology Physician in Aurora, CO
• Providers in Aurora, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.