Individual provider Active NPI

Charles Bradford Goodwin, M.D.

  • Orthopaedic Surgery Physician
  • New York, NY
National Provider Identifier
1326044314
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
130637 Issued in NY
Practice address
635 Madison Ave
FL 7
New York, NY 10022-1009
Phone
(212) 857-4600
Fax
(212) 752-2454
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 130637 NY Primary

Addresses

Primary practice location

635 Madison Ave
FL 7
New York, NY 10022-1009

Mailing address

635 Madison Ave
FL 7
New York, NY 10022-1009
Phone (212) 317-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050308000582 NY Practitioner - Orthopedic Surgery 5799739462 Reassigns benefits to 1 organization
Practice locations: Massapequa, NY; Uniondale, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Cincinnati College of Medicine, 1976
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

333 Earle Ovington Blvd
Suite 106
Uniondale, NY 11553-3645
Phone (212) 606-1052

4160 Merrick Rd
Massapequa, NY 11758-6000
Phone (212) 606-1052

523 E 72ND St
FL 2
New York, NY 10021-4099
Phone (212) 606-1052

535 E 70TH St
New York, NY 10021-4823
Phone (212) 606-1052

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion91
Laminectomy or laminotomy (partial removal of spine bones)57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130637NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Darren R. Lebl, MD PC CurrentSince Feb 1, 2023 Accepting new patients
Orthopedic Specialists of New York Orthopaedic Surgery Past Accepting new patients

Locations

4160 Merrick Rd
Massapequa, NY 11758
Phone (516) 541-9000

635 Madison Ave
Fl 7
New York, NY 10022
Phone (212) 317-4500

535 E 70th St
New York, NY 10021

523 E 72nd St
New York, NY 10021
Phone (212) 606-1052

523 E 72nd St
Fl 2
New York, NY 10021
Phone (212) 606-1052

333 Earle Ovington Blvd
Ste 106
Uniondale, NY 11553
Phone (212) 606-1136

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1326044314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE",
            "address_2": "FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-317-4600",
            "fax_number": "212-759-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE",
            "address_2": "FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-857-4600",
            "fax_number": "212-752-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "CHARLES",
        "middle_name": "BRADFORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "130637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.