Active NPI
David L Goodman, D.C.
- Chiropractor
- Philadelphia, PA
National Provider Identifier
1619922168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC007666L
- Practice address
- 7256 Rising Sun Ave
Philadelphia, PA 19111-3948 - Phone
- (215) 725-3979
- Fax
- (215) 725-5146
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC007666L | PA | Primary |
Addresses
Primary practice location
7256 Rising Sun Ave
Philadelphia, PA 19111-3948
Mailing address
7256 Rising Sun Ave
Philadelphia, PA 19111-3948
Phone (215) 725-3979
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1954945 | Medicaid | PA | |
| 853138 | Other | PA | BLUE CROSS BLUE SHIELD |
| 34424 | Other | PA | HEALTH PARTNERS |
| 0777297000 | Other | PA | PERSONAL CHOICE |
| 0777297000 | Other | PA | KEYSTONE HEALTH PLAN EAST |
| 3503293 | Other | PA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101216000429 | PA | Practitioner - Chiropractic | 6002004157 | Practice locations: Philadelphia, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7256 Rising Sun Ave
Phila, PA 19111-3948
Phone (215) 724-3979
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1619922168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7256 RISING SUN AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191113948",
"telephone_number": "215-725-3979",
"fax_number": "215-725-5146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7256 RISING SUN AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191113948",
"telephone_number": "215-725-3979",
"fax_number": "215-725-5146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "DAVID",
"middle_name": "L",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC007666L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1954945",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "853138",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "34424",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CHOICE",
"identifier": "0777297000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HEALTH PLAN EAST",
"identifier": "0777297000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3503293",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.