Andrew Blake Goode, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2964 Issued in ID

Practice address

335 E Lewis St
Ste 10
Pocatello, ID 83201-6408

Phone

(208) 269-2360

Fax

(208) 550-3256

NPI assigned

Jun 4, 2013

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 ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Streamline Sports Physical Therapy PCGroup PAC ID 7810262219, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Streamline Sports Physical Therapy PC

  • Physical Therapist
  • Pocatello, ID
  • NPI 1073038378
  Medicare reassignment Care Compare group NPD
• McDonald Rehab, PC

  • Physical Therapist
  • Pocatello, ID
  • NPI 1497948509
  Medicare reassignment NPD

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1447698113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 E LEWIS ST",
            "address_2": "STE 10",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016408",
            "telephone_number": "208-269-2360",
            "fax_number": "208-550-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E LEWIS ST",
            "address_2": "STE 10",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016408",
            "telephone_number": "208-269-2360",
            "fax_number": "208-550-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "ANDREW",
        "middle_name": "BLAKE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivan Alexis Gonzales
• Karen Larissa Gonzalez, LMSW
• Linda Gonzalez
• Mauricio C Gonzalez
• Good Blood PLLC
• Jonathan Hancock Goodman, DPT
• Nancy Goodman, LPC
• Teresa L Goodwin, COTA
• Lauren Gorrebeeck
• Joseph Gorriceta

• Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.