Active NPI
Madeline A Goodman, DO
- Psychiatry Physician
- Portland, ME
National Provider Identifier
1295830636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1580
- 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.
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Pediatric Urology Physician
- Portland, ME
- NPI 1457540486
-
- Community/Behavioral Health Agency
- Bangor, ME
- NPI 1215102850
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Biddeford, ME
- NPI 1891733309
-
- General Acute Care Hospital
- Portland, ME
- NPI 1427313048
-
- Clinical Social Worker
- Portland, ME
- NPI 1841369568
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.
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1580 | ME | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Acadia Hospital Corp | Current | 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1580 | ME | Primary |
Addresses
NPPES NPI RegistryPrimary 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.
- 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.