Individual provider Active NPI

Gregory Goodwin, M.D.

  • Pediatric Endocrinology Physician
  • Boston, MA
National Provider Identifier
1326002817
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
071016 Issued in MA
Practice address
333 Longwood Ave
Boston, MA 02115-5711
Phone
(617) 355-7476
NPI assigned
Apr 13, 2006
Last updated
May 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 071016 MA Primary

Addresses

Primary practice location

333 Longwood Ave
Boston, MA 02115-5711

Mailing address

59 Manchester Ave
Somerset, MA 02726-4043

Other identifiers 1

IdentifierTypeStateIssuer
7007517MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050207000457 MA Practitioner - Pediatric MedicinePractitioner - Endocrinology 5698726719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Endocrinology
Education
Johns Hopkins University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children's Hospital Pediatric Associates, IncGroup PAC ID 3476541830, 333 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071016MAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Pediatric Associates, Inc Pediatric Endocrinology CurrentSince Apr 15, 2003 Accepting new patients
Pratt Pediatric Associates Inc Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

Interoperability endpoints

  • Direct secure messaging: ggoodwin21946@direct.bostonchildrens.org

Organizations & group practices 2

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1326002817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 MANCHESTER AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027264043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155711",
            "telephone_number": "617-355-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MA",
            "license": "071016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7007517",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.