Individual provider Active NPI

Richard Duane Goodenough, MD

  • Surgery Physician
  • Danvers, MA
National Provider Identifier
1568431641
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
46582 Issued in MA
Practice address
104 Endicott St
Suite 200
Danvers, MA 01923-3623
Phone
(978) 882-6868
Fax
(978) 882-6828
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 46582 MA Primary
Vascular Surgery Physician 2086S0129X 46582 MA

Addresses

Primary practice location

104 Endicott St
Suite 200
Danvers, MA 01923-3623

Mailing address

104 Endicott St
Suite 200
Danvers, MA 01923-3623
Phone (978) 882-6868

Other identifiers 1

IdentifierTypeStateIssuer
6192947MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050325000424 MA Practitioner - General SurgeryPractitioner - Vascular Surgery 9931155660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Michigan Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 Endicott St
MGH North Shore Medical
Danvers, MA 01923-3623
Phone (978) 882-6100

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46582MAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Surgery CurrentSince Jul 23, 2014 Accepting new patients
The General Hospital Corporation CurrentSince Jul 23, 2014 Accepting new patients
General Hospital Corp Current Accepting new patients
Essex Surgical Associates, PC Surgery Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

104 Endicott St
Ste 200
Danvers, MA 01923
Phone (978) 882-6868

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: goodenough.richard.mgh@direct.partners.masshiway.net

Organizations & group practices 4

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 1

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1568431641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 200",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-882-6868",
            "fax_number": "978-882-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST",
            "address_2": "SUITE 200",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233623",
            "telephone_number": "978-882-6868",
            "fax_number": "978-882-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODENOUGH",
        "first_name": "RICHARD",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "46582",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "46582",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6192947",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.