Active NPI
Bruce M. Goens, MD
- Internal Medicine Physician
- Carmel, IN
National Provider Identifier
1396759940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01027055A
- Practice address
- 11725 N Illinois St
Ste 325
Carmel, IN 46032-3002 - Phone
- (317) 688-5800
- Fax
- (317) 688-5805
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01027055A | IN | Primary |
Addresses
Primary practice location
11725 N Illinois St
Ste 325
Carmel, IN 46032-3002
Mailing address
250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00887146 | Other | IN | RAILROAD MEDICARE PTAN |
| 000000313300 | Other | IN | ANTHEM |
| 100062890 | Medicaid | IN | |
| P00081860 | Other | IN | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Internal Medicine | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1396759940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"address_2": "STE 130 PROVIDER ENROLLMENT",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11725 N ILLINOIS ST",
"address_2": "STE 325",
"city": "CARMEL",
"state": "IN",
"postal_code": "460323002",
"telephone_number": "317-688-5800",
"fax_number": "317-688-5805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOENS",
"first_name": "BRUCE",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01027055A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00887146",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000313300",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100062890",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00081860",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.