Mark J Goedken, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31916 Issued in IA

Practice address

1515 42ND St NE
Cedar Rapids, IA 52402-3061

Phone

(319) 365-7581

Fax

(319) 365-0163

NPI assigned

Sep 22, 2005

Last updated

Jun 23, 2022By the provider in NPPES

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 IA

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

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Home Care Home health agency, Cedar Rapids, IA, CCN 167151
• Virginia Gay Hospital Hospital, Vinton, IA, CCN 161349
• St Lukes Hospital Hospital, Cedar Rapids, IA, CCN 160045
• Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgoedken40620@direct.unitypoint.org

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.

• Family Physicians of Cedar Rapids, P.C.

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1285663849
  Medicare reassignment Authorized official
• Family Physicians of Cedar Rapids, P.C.

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1609108711
  NPD Authorized official
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Practice of Family Medicine, P.C.

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1487731402
  NPD (past)

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

• Mercy Medical Center

  dba Mercy Home Care

  • Home Health Agency
  • Cedar Rapids, IA
  • NPI 1639119332
  Care Compare affiliation
• Mercy Medical Center

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1720029333
  Care Compare affiliation
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  Care Compare affiliation
• Virginia Gay Hospital, Inc

  • Critical Access Hospital
  • Vinton, IA
  • NPI 1164486726
  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1386630663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023061",
            "telephone_number": "319-365-7581",
            "fax_number": "319-365-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023061",
            "telephone_number": "319-365-7581",
            "fax_number": "319-365-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDKEN",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "31916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4140400",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glory Days Care Services LLC
• Michael Goad
• Goatextensions
• Joanna Godbey, ARNP
• Chanel D Godonu
• Goeller Chiropractic PC (Goeller Chiropractic)
• Jacob Robert Goeller, DC
• Kendal Goering, DPT
• Vijaya Kumar Gogineni, MD
• Jenna Lee Goldsmith

• Family Medicine Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.