Individual provider Active NPI

Benjamin Matthew Goozen, PHARM D.

  • Pharmacist
  • Surprise, AZ
National Provider Identifier
1376837641
Registry record updated Jun 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S017355 Issued in AZ
Practice address
13731 W Bell Rd
T-1335
Surprise, AZ 85374-3871
Phone
(623) 975-4379
Fax
(623) 975-4379
NPI assigned
Jun 4, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S017355 AZ Primary

Addresses

Primary practice location

13731 W Bell Rd
T-1335
Surprise, AZ 85374-3871

Mailing address

13731 W Bell Rd
T-1335
Surprise, AZ 85374-3871
Phone (623) 975-4379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S017355AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1376837641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13731 W BELL RD",
            "address_2": "T-1335",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743871",
            "telephone_number": "623-975-4379",
            "fax_number": "623-975-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13731 W BELL RD",
            "address_2": "T-1335",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743871",
            "telephone_number": "623-975-4379",
            "fax_number": "623-975-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOZEN",
        "first_name": "BENJAMIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-04",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.