Individual provider Active NPI

Mark Quincy Goodman, M.D.

  • Sports Medicine (Emergency Medicine) Physician
  • Bend, OR
National Provider Identifier
1609018860
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
MD160709 Issued in OR
Practice address
1140 SW Simpson Ave Ste 100
Bend, OR 97702-3789
Phone
(541) 388-2333
Fax
(541) 388-0930
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD160709 OR
Sports Medicine (Emergency Medicine) Physician 207PS0010X MD160709 OR Primary

Addresses

Primary practice location

1140 SW Simpson Ave Ste 100
Bend, OR 97702-3789

Mailing address

1140 SW Simpson Ave Ste 100
Bend, OR 97702-3789
Phone (541) 388-2333

Other identifiers 1

IdentifierTypeStateIssuer
1609018860OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20130215000251 OR Practitioner - Emergency Medicine 2668643008 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Sports and Spine LLCGroup PAC ID 3971941154, 7 clinicians

Practice addresses (Care Compare)

1140 SW Simpson Ave
Suite 100
Bend, OR 97702-3789
Phone (541) 388-2333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD160709ORMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Sports and Spine, LLC Current Accepting new patients
Central Oregon Emergency Physicians LLC Emergency Medical Services CurrentSince May 9, 2016 Accepting new patients
St. Charles Health System, Inc. Emergency Medicine Current Accepting new patients
High Desert Sports and Spine, LLC Emergency Medical Services CurrentSince Apr 1, 2024 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 6, 2015 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 6, 2015 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 6, 2015 Accepting new patients
St. Charles Health System, Inc. Family Medicine CurrentSince Jan 6, 2015 Accepting new patients
University of Utah Emergency Physicians Emergency Medicine Past Accepting new patients
University of Utah Emergency Physicians Emergency Medical Services Past Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

1140 SW Simpson Ave
Ste 100
Bend, OR 97702
Phone (541) 388-2333

13000 SW Century Dr
Bend, OR 97702
Phone (541) 706-5499

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

1303 NE Cushing Dr
Ste 100
Bend, OR 97701
Phone (541) 330-8226

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Interoperability endpoints

  • Direct secure messaging: mark.goodman.1@30625.direct.athenahealth.com

Organizations & group practices 12

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 2

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": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1609018860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 SW SIMPSON AVE STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023789",
            "telephone_number": "541-388-2333",
            "fax_number": "541-388-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SW SIMPSON AVE STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023789",
            "telephone_number": "541-388-2333",
            "fax_number": "541-388-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MARK",
        "middle_name": "QUINCY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OR",
            "license": "MD160709",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "OR",
            "license": "MD160709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609018860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.