Individual provider Active NPI

Madeline A Goodman, DO

  • Psychiatry Physician
  • Portland, ME
National Provider Identifier
1295830636
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1580 Issued in ME
Practice address
63 Vannah Ave
Portland, ME 04103-4510
Phone
(207) 671-5891
Fax
(207) 773-5190
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 9

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.

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Philadelphia College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Acadia Hospital Corp. 88 clinicians

Practice addresses (Care Compare)

268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20040630000526 ME Practitioner - Psychiatry 5395722110 Reassigns benefits to 2 organizations
Practice locations: Portland, ME

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1580MEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 8, 2011 Accepting new patients
Mainehealth CurrentSince Sep 8, 2011 Accepting new patients
Mainehealth Current Accepting new patients
Acadia Hospital Corp CurrentSince Mar 2, 2025 Accepting new patients
Mercy Hospital Past Accepting new patients
Cornerstone Behavioral Healthcare, LLC Past Accepting new patients
University of New England Psychiatry Past Accepting new patients
RLH Inc Past Accepting new patients
Maine Behavioral Healthcare Past Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

78 Atlantic Pl
South Portland, ME 04106
Phone (207) 661-6654

474 Main St
Springvale, ME 04083
Phone (207) 324-1500

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1580 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

63 Vannah Ave
Portland, ME 04103-4510

Mailing address

63 Vannah Ave
Portland, ME 04103-4510
Phone (207) 671-5891

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 30, 2024.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1295830636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 VANNAH AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034510",
            "telephone_number": "207-671-5891",
            "fax_number": "207-773-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 VANNAH AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034510",
            "telephone_number": "207-671-5891",
            "fax_number": "207-773-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MADELINE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "1580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.