Individual provider Active NPI

Richard M. Goodale, M.D.

  • General Practice Physician
  • Kapaa, HI
National Provider Identifier
1639274202
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD-4740 Issued in HI
Practice address
4-1105 Kuhio Hwy
Kapaa, HI 96746-1665
Phone
(808) 822-3431
Fax
(808) 822-2798
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD-4740 HI Primary

Addresses

Primary practice location

4-1105 Kuhio Hwy
Kapaa, HI 96746-1665

Mailing address

3-3420 Kuhio Highway
Suite B
Lihue, HI 96766-1098
Phone (808) 822-3431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041215000170 HI Practitioner - General Practice 4284691825 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kauai Medical Clinic CurrentSince May 1, 1996 Accepting new patients
Kauai Medical Clinic CurrentSince May 1, 1996 Accepting new patients

Locations

1946 Young St
Ste 320
Honolulu, HI 96826

4-1105 Kuhio Hwy
Kapaa, HI 96746
Phone (808) 822-3431

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1639274202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3-3420 KUHIO HIGHWAY",
            "address_2": "SUITE B",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661098",
            "telephone_number": "808-822-3431",
            "fax_number": "808-822-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-1105 KUHIO HWY",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461665",
            "telephone_number": "808-822-3431",
            "fax_number": "808-822-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODALE",
        "first_name": "RICHARD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "HI",
            "license": "MD-4740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapaa, HI

Sources for this page

Verify at the official NPI Registry.