Individual provider Active NPI

Mark P Goodman, M.D.

  • Internal Medicine Physician
  • Beverly Hills, CA
National Provider Identifier
1477659407
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G081205 Issued in CA
Practice address
435 N Roxbury Dr
Suite 300
Beverly Hills, CA 90210-5027
Phone
(310) 271-6889
Fax
(310) 278-5765
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G081205 CA Primary

Addresses

Primary practice location

435 N Roxbury Dr
Suite 300
Beverly Hills, CA 90210-5027

Mailing address

435 N Roxbury Dr
Suite 300
Beverly Hills, CA 90210-5027
Phone (310) 271-6889

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120813000099 CA Practitioner - Internal Medicine 7113173873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

435 N Roxbury Dr
Suite 300
Beverly Hills, CA 90210-5005
Phone (310) 271-6889

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
81205CAMDClinical Social Worker
G081205CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark P Goodman MD Inc CurrentSince Jan 2, 2014 Accepting new patients
Cory a Waldman M D a Professional Corporation Past Accepting new patients

Locations

435 N Roxbury Dr
Ste 300
Beverly Hills, CA 90210
Phone (310) 273-7430

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477659407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR",
            "address_2": "SUITE 300",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105027",
            "telephone_number": "310-271-6889",
            "fax_number": "310-278-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR",
            "address_2": "SUITE 300",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105027",
            "telephone_number": "310-271-6889",
            "fax_number": "310-278-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G081205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.