Mark Clifford Goodwin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A70773 Issued in CA

Practice address

36977 Park Ave
Burney, CA 96013-4067

Phone

(530) 335-3651

Fax

(530) 335-3632

NPI assigned

Mar 14, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

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

General Practice

Education

State University of Ny Upstate Medical University, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sonoma County Indian Health Project IncGroup PAC ID 2961491238, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.goodwin.p1@direct.scihp.nextgenshare.com
• Direct secure messaging: mgoodwin764151@direct.ochin.org

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.

• Sonoma County Indian Health Project, Inc

  dba Scihp

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1265457980

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Fort Bidwell Indian Community

  • Rural Health Clinic/Center
  • Fort Bidwell, CA
  • NPI 1093931107
  NPD (past)
• Sonoma County Indian Health Project, Inc

  dba Sonoma County Indian Health Project Pharmacy

  • Community/Retail Pharmacy
  • Santa Rosa, CA
  • NPI 1568461267
  NPD (past)
• Sonoma County Indian Health Project, Inc

  • Federally Qualified Health Center (FQHC)
  • Point Arena, CA
  • NPI 1578729380

  Family Medicine

  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)

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

• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1396713434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36977 PARK AVE",
            "city": "BURNEY",
            "state": "CA",
            "postal_code": "960134067",
            "telephone_number": "530-335-3651",
            "fax_number": "530-335-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36977 PARK AVE",
            "city": "BURNEY",
            "state": "CA",
            "postal_code": "960134067",
            "telephone_number": "530-335-3651",
            "fax_number": "530-335-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "MARK",
        "middle_name": "CLIFFORD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A70773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Calvin Lim Freking, PA-C
• Tiffany Lynn Frye, D.O.
• Lewis Edgar Furber Jr., FNP
• Fred A Gideon, LCSW
• Jeanine Wynn Gonzales
• Amanda Harris, APCC
• Robert Ernest Hatcher, DDS
• Christopher James Hedgecock, DPT
• Henry D Patterson, OD a Professional Optometric Corporation (Patterson Optometric Eyecare)
• Hill Country Community Clinic

• Family Medicine Physician in Burney, CA
• Providers in Burney, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.