Individual provider Active NPI

Merton Bernard Goode, MD

  • Anesthesiology Physician
  • San Pablo, CA
National Provider Identifier
1295775039
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
C37235 Issued in CA
Practice address
2000 Vale Rd
San Pablo, CA 94806-3808
Phone
(510) 970-5000
Fax
(510) 970-5761
NPI assigned
Jun 8, 2006
Last updated
Oct 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C37235 CA Primary

Addresses

Primary practice location

2000 Vale Rd
San Pablo, CA 94806-3808

Mailing address

PO Box 7793
San Francisco, CA 94120-7793

Other identifiers 1

IdentifierTypeStateIssuer
00C372350MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C37235CAMDAnesthesiology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1295775039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7793",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941207793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VALE RD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063808",
            "telephone_number": "510-970-5000",
            "fax_number": "510-970-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "MERTON",
        "middle_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C37235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C372350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.