Individual provider Active NPI

Justin S Goodman, MD

  • Gastroenterology Physician
  • Seattle, WA
National Provider Identifier
1538125331
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD00039271 Issued in WA
Practice address
1145 Broadway
Seattle, WA 98122-4201
Phone
(206) 860-5583
Fax
(206) 860-2347
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD00039271 WA Primary

Addresses

Primary practice location

1145 Broadway
Seattle, WA 98122-4201

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 1

IdentifierTypeStateIssuer
1012711MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20041006001477 WA Practitioner - GastroenterologyPractitioner - Internal Medicine 2264491000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of California, San Diego School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 309-1760

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy56
Upper gastrointestinal (GI) endoscopy for acid reflux40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00039271WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC CurrentSince Apr 1, 2015 Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 1, 2004 Accepting new patients
The Polyclinic PLLC CurrentSince Apr 1, 2015 Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 1, 2004 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1145 Broadway
Seattle, WA 98122

Interoperability endpoints

  • Direct secure messaging: jgoodman22086@direct.tecmc.com

Organizations & group practices 6

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1538125331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-860-5583",
            "fax_number": "206-860-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JUSTIN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00039271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012711",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.