Individual provider Active NPI

Thomas A Goodwin, DO

  • Family Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1568481448
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101015999 Issued in MI
Practice address
8088 Vineyard Pkwy
Kalamazoo, MI 49009-3892
Phone
(269) 286-7090
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 5101015999 MI
Family Medicine Physician 207Q00000X 5101015999 MI Primary

Addresses

Primary practice location

8088 Vineyard Pkwy
Kalamazoo, MI 49009-3892

Mailing address

8088 Vineyard Pkwy
Kalamazoo, MI 49009-3892

Other identifiers 3

IdentifierTypeStateIssuer
1598712390OtherMIGROUP NPI
0854111605OtherMIBCBS
4898142MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060830000097 MI Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Sports Medicine 5799789061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Michigan State University College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

8088 Vineyard Pkwy
Kalamazoo, MI 49009-3892
Phone (269) 286-7090

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101015999MIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed Family Medicine Current Accepting new patients
Promed Healthcare CurrentSince Jul 28, 2008 Accepting new patients
Ascension Medical Group Promed CurrentSince Jul 28, 2008 Accepting new patients
Bronson Methodist Hospital CurrentSince Jul 1, 2020 Accepting new patients
Western Michigan University School of Medicine Past Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

8088 Vineyard Pkwy
Kalamazoo, MI 49009
Phone (269) 286-7090

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

7901 Angling Rd
Ste B-201
Portage, MI 49024
Phone (269) 324-8600

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

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.

Hospital & facility affiliations 5

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1568481448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8088 VINEYARD PKWY",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8088 VINEYARD PKWY",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093892",
            "telephone_number": "269-286-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101015999",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1598712390",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0854111605",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4898142",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.