Juan Godinez, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

N6314 Issued in TX

Practice address

2010 Ben Merritt Dr Unit a
Decatur, TX 76234-3853

Phone

(940) 626-2300

Fax

(940) 626-2315

NPI assigned

Apr 28, 2006

Last updated

Jun 14, 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 4

Addresses

Other identifiers 6

Other names 1

• Juan Godinez-Puebla Other name

Medicare fee-for-service enrollment

Enrolled in TX, NY, GA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• North Texas Cancer Center LP

  • Radiation Oncology Physician
  • Plano, TX
  • NPI 1245358183
  Medicare reassignment NPD
• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333

  Radiation Oncology

  Medicare reassignment NPD
• Clifton Springs Sanitarium Co

  dba Clifton Springs Hospital and Clinic

  • General Acute Care Hospital
  • Clifton Springs, NY
  • NPI 1366505463
  Medicare reassignment NPD
• United Memorial Medical Center

  • General Acute Care Hospital
  • Batavia, NY
  • NPI 1902800352
  Medicare reassignment NPD
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608
  Medicare reassignment NPD
• Memorial Southside Cancer Center LLC

  dba Memorial Cancer Center

  • Radiation Oncology Clinic/Center
  • Jacksonville, FL
  • NPI 1588724033
  NPD
• United Memorial Medical Center

  • Family Medicine Physician
  • Batavia, NY
  • NPI 1669747085
  NPD
• Southlake Oncology

  • Medical Oncology Physician
  • Southlake, TX
  • NPI 1518147594
  NPD (past)
• Texas Oncology Care, PLLC

  • Clinic/Center
  • Irving, TX
  • NPI 1205863263

  Radiation Oncology

  NPD (past)
• Integrated Community Oncology Network LLC

  dba Florida Radiation Oncology Group

  • Radiation Oncology Physician
  • Jacksonville, FL
  • NPI 1043230402
  NPD (past)
• Integrated Community Oncology Network LLC

  dba Florida Radiation Oncology Group

  • Diagnostic Radiology Physician
  • Orange Park, FL
  • NPI 1548295850
  NPD (past)
• Integrated Community Oncology Network LLC

  dba Florida Radiation Oncology Group

  • Radiation Oncology Physician
  • Jacksonville Beach, FL
  • NPI 1760417042
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1417914847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 LAS COLINAS BLVD STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750637569",
            "telephone_number": "214-379-2722",
            "fax_number": "972-869-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BEN MERRITT DR UNIT A",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343853",
            "telephone_number": "940-626-2300",
            "fax_number": "940-626-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODINEZ",
        "first_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME70845",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MA",
            "license": "220850",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CO",
            "license": "CDR.0001781",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "N6314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "44853",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01875021",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364030201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "251521",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258329100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00862529",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "GODINEZ-PUEBLA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gilbert Berdine MD
• George Keith Gill, MD
• Lea Anne Gilley, FNP-C
• Kushal Giri
• Catherine Givens
• Martha Janeth Gomez
• Governors Ridge Opco LLC
• William W. Grimes, D.O.
• David Grudzinski, PT, DPT
• John Scott Gwilliam, PT, CWS

• Radiation Oncology Physician in Decatur, TX
• Providers in Decatur, TX by specialty
• Radiation Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.