Organization Active NPI

Goodside Health Medical, PLLC

  • Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1467181305
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GOODSIDE HEALTH MEDICAL, PLLC
Practice address
307 4TH Ave Ste 503
Pittsburgh, PA 15222-2120
Phone
(281) 203-5006
NPI assigned
Jun 7, 2022
Last updated
Jul 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Gerardo Reyes, MDNPI 1194767954
Title
Owner
Phone
(281) 203-5006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X Primary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

307 4TH Ave Ste 503
Pittsburgh, PA 15222-2120

Mailing address

1701 River Run Ste 302
Fort Worth, TX 76107-6547
Phone (281) 203-5006

National Provider Directory

National Provider Directory
Tax ID family
Goodside Health Medical PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

307 4th Ave
Ste 503
Pittsburgh, PA 15222
Phone (412) 434-0855

1701 River Run
Ste 302
Ft Worth, TX 76107
Phone (512) 857-1222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1467181305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 RIVER RUN STE 302",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076547",
            "telephone_number": "281-203-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 4TH AVE STE 503",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152222120",
            "telephone_number": "281-203-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODSIDE HEALTH MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-203-5006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.