John W Goulart, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4191 Issued in OK

Practice address

620 S Madison St
Suite 108
Enid, OK 73701-7270

Phone

(580) 234-2289

Fax

(580) 249-4350

NPI assigned

Jul 26, 2005

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 3

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgoulart8518@direct.integrisok.com

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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD
• Integris Bass Baptist Health Center

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1144236571
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788652800000",
    "number": "1417957085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "580-234-2289",
            "fax_number": "580-249-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S MADISON ST",
            "address_2": "SUITE 108",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017270",
            "telephone_number": "580-234-2289",
            "fax_number": "580-249-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULART",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2026-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "4191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200032320A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00155199",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OSU AJ",
            "identifier": "200032320B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gonzales SLP Services, PLLC
• Morgan Leigh Gonzales
• Holly Good
• Shannon Kristine Goodwin, LPC
• Courtney Goucher
• Grace Care Inc
• Lauren Gragg, BCBA
• David L Graham, M.D.
• Grand Lake Mental Health Center, Inc.
• Grand Lake Mental Health Center, Inc.

• Surgery Physician in Enid, OK
• Providers in Enid, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; 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.