Maangelica Goodstein, P.T, DPT, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1227 Issued in NV

Practice address

3900 Paradise Rd Ste V
Las Vegas, NV 89169-0930

Phone

(702) 369-0560

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Ma Angelica Eugenio Perez Former name

Medicare fee-for-service enrollment

Enrolled in OR, AK2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Providence Health & Services- Washington

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278

  Multi-Specialty

  Medicare reassignment NPD
• Providence Health & Services-Washington

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1841814795

  Multi-Specialty

  NPD
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1295944437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 PEACHY CANYON CIR UNIT 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891440894",
            "telephone_number": "702-758-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PARADISE RD STE V",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891690930",
            "telephone_number": "702-369-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSTEIN",
        "first_name": "MAANGELICA",
        "name_prefix": "Mrs.",
        "credential": "P.T, DPT, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2497",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "1227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MA ANGELICA",
            "last_name": "PEREZ",
            "middle_name": "EUGENIO",
            "prefix": "MS.",
            "credential": "PT, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allena Goodson
• Cedraya Goodson
• Donald Goodson
• Mycheal Goodson
• Tina L Goodson, M.D.
• Goodwill Health Care LLC
• Goodwill Home Health LLC
• Goodwill Pharmacy Inc.
• Goodwill Ventures Inc
• Ellen Goodwill

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.