Individual provider Active NPI

Brooke Alayne Goodman, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Francisco, CA
National Provider Identifier
1417296245
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5159 Issued in CA
Practice address
4150 Clement St
Podiatry Surgery Service 112
San Francisco, CA 94121-1545
Phone
(415) 221-4810
NPI assigned
Feb 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5159 CA Primary

Addresses

Primary practice location

4150 Clement St
Podiatry Surgery Service 112
San Francisco, CA 94121-1545

Mailing address

4150 Clement St
Podiatry Surgery Service 112
San Francisco, CA 94121-1545
Phone (415) 221-4810

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170627001496 CA Order and Referring Only - PodiatryPractitioner - Podiatry 9335418870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1417296245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "address_2": "PODIATRY SURGERY SERVICE 112",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-221-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "address_2": "PODIATRY SURGERY SERVICE 112",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "BROOKE",
        "middle_name": "ALAYNE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "5159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.