Individual provider Active NPI

Marlee Rose Goff, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1457910093
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007181 Issued in IL
Practice address
635 N Dearborn St Ste 100
Chicago, IL 60654-4618
Phone
(312) 694-2273
Fax
(312) 694-2129
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5340-23 WI
Physician Assistant 363A00000X 085007181 IL Primary

Addresses

Primary practice location

635 N Dearborn St Ste 100
Chicago, IL 60654-4618

Mailing address

635 N Dearborn St
St 100
Chicago, IL 60654-4618
Phone (312) 694-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190918003517 IL Practitioner - Physician Assistant 3577893460
I20210423001800 WI Practitioner - Physician Assistant 3577893460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Wisconsin Em SCGroup PAC ID 2466814538, 56 clinicians

Practice addresses (Care Compare)

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085007181ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Vituity-Wisconsin Em SC CurrentSince Oct 27, 2025 Accepting new patients
Central Dupage Physician Group PastSince Aug 18, 2019 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Interoperability endpoints

  • Direct secure messaging: marlee.goff.1@20105.direct.athenahealth.com
  • Direct secure messaging: mgoff500146@direct.froedtert.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1457910093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N DEARBORN ST",
            "address_2": "ST 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544618",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N DEARBORN ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544618",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "MARLEE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5340-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.