Individual provider Active NPI

Warren J Goodman, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • New York, NY
National Provider Identifier
1558373217
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
003926 Issued in NY
Practice address
83 Maiden LN FL 6
New York, NY 10038-4812
Phone
(212) 780-2378
NPI assigned
Aug 12, 2006
Last updated
Sep 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 003926 NY Primary

Addresses

Primary practice location

83 Maiden LN FL 6
New York, NY 10038-4812

Mailing address

906 Cranford Ave
Valley Stream, NY 11581-3114
Phone (516) 791-5701

Other identifiers 1

IdentifierTypeStateIssuer
00904201MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070314000419 NY Practitioner - Podiatry 3870696792 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Healthcare IncGroup PAC ID 1254233158, 58 clinicians

Practice addresses (Care Compare)

380 Ave U
1L
Brooklyn, NY 11223-4046
Phone (718) 376-3077

460 W 34TH St
FL 9
New York, NY 10001-2382
Phone (212) 273-6100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions15
Removal of nail tissue129
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003926NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Highway Podiatry PC Primary Podiatric Medicine CurrentSince Jul 3, 2008 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Ahrc Health Care Inc CurrentSince Feb 1, 2011 Accepting new patients
Premier Healthcare, Inc. CurrentSince Oct 20, 1999 Accepting new patients
Premier Healthcare, Inc. CurrentSince Oct 20, 1999 Accepting new patients
Ahrc Healthcare Inc. CurrentSince Feb 1, 2011 Accepting new patients
Kings Highway Podiatry Past Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
Ste 2
Bayside, NY 11361

1500 Pelham Pkwy S
Bronx, NY 10461
Phone (718) 409-8225

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

3060 E Tremont Ave
#2
Bronx, NY 10461

175 Remsen St
Brooklyn, NY 11201
Phone (718) 303-1300

175 Remsen St
Fl 4
Brooklyn, NY 11201
Phone (212) 273-6182

18 Adams St
Brooklyn, NY 11201
Phone (718) 285-3035

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

3364 Nostrand Ave
Brooklyn, NY 11229
Phone (347) 570-5348

380 Avenue U
Apt 1L
Brooklyn, NY 11223
Phone (718) 339-4470

380 Avenue U
Ste 1
Brooklyn, NY 11223

380 Avenue U
Ste 1L
Brooklyn, NY 11223
Phone (718) 376-3077

21111 Northern Blvd
Fl 2
Flushing, NY 11361
Phone (718) 224-2094

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

83 Maiden Ln
Fl 6
New York, NY 10038
Phone (212) 780-2378

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: warren.goodman.p1@direct.premierhealthcare.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1558373217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 CRANFORD AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813114",
            "telephone_number": "516-791-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 MAIDEN LN FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384812",
            "telephone_number": "212-780-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "WARREN",
        "middle_name": "J",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "003926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00904201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.