Gary Neal Goodman, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3196 Issued in AZ

Practice address

11110 N Tatum Blvd
Suite 103
Phoenix, AZ 85028-1607

Phone

(602) 432-0800

Fax

(623) 516-0637

NPI assigned

Aug 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Geriatric and Family Mental Health Services, LLC

  • Psychologist
  • Phoenix, AZ
  • NPI 1679566624
  Medicare reassignment NPD Authorized official
• A Wisermind LLC

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1053619874
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  dba Northern Arizona Healthcare - Sedona

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1316930381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 N TATUM BLVD",
            "address_2": "103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281607",
            "telephone_number": "602-432-0800",
            "fax_number": "602-443-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 N TATUM BLVD",
            "address_2": "SUITE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281607",
            "telephone_number": "602-432-0800",
            "fax_number": "623-516-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "GARY",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451352",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleb Goodman, DMD
• Carolinie Ellen Goodman, R.D.
• Darla Kathleen Goodman, M.S. OTR/L
• Emily Goodman, MD
• Estella Dawn Goodman
• Herbert D Goodman, M.D.
• Jessica M Goodman, PT
• Leigh Anne Goodman, DO
• Megan Goodman, PA-C
• Mina Ariella Goodman, RD

• Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.