Individual provider Active NPI

Lee Goozdich, D. C.

  • Chiropractor
  • Brownsville, PA
National Provider Identifier
1477657948
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0035424L Issued in PA
Practice address
565 National Pike W
Brownsville, PA 15417-9221
Phone
(724) 785-7633
Fax
(724) 785-7632
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0035424L PA Primary

Addresses

Primary practice location

565 National Pike W
Brownsville, PA 15417-9221

Mailing address

122 Scenic Ridge Dr
Venetia, PA 15367-2342
Phone (724) 942-3836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201102002129 AZ Practitioner - Chiropractic 5597932145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1345 E Chandler Blvd
Suite 105
Phoenix, AZ 85048-6280
Phone (480) 912-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0035424LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Best Life Counseling and Wellness LLC CurrentSince Jul 25, 2020 Accepting new patients
Tukee Lifestyle Chiropractic PLC Chiropractor CurrentSince Jul 25, 2020 Accepting new patients
Stay Fit Chiropractic, P.C. Chiropractor PastSince Oct 13, 2019 Accepting new patients

Locations

1345 E Chandler Blvd
Ste 105
Phoenix, AZ 85048
Phone (480) 912-4040

Organizations & group practices 3

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1477657948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SCENIC RIDGE DR",
            "city": "VENETIA",
            "state": "PA",
            "postal_code": "153672342",
            "telephone_number": "724-942-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 NATIONAL PIKE W",
            "city": "BROWNSVILLE",
            "state": "PA",
            "postal_code": "154179221",
            "telephone_number": "724-785-7633",
            "fax_number": "724-785-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOZDICH",
        "first_name": "LEE",
        "credential": "D. C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC0035424L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.