Individual provider Active NPI

Peter Goodwin, MD

  • Ophthalmology Physician
  • Greenville, SC
National Provider Identifier
1649488594
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
33461 Issued in SC
Practice address
113 Doctors Dr
Greenville, SC 29605-5608
Phone
(864) 269-3333
NPI assigned
May 21, 2007
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 26156 AL
Ophthalmology Physician 207W00000X 33461 SC Primary

Addresses

Primary practice location

113 Doctors Dr
Greenville, SC 29605-5608

Mailing address

1126 Grove Rd
Greenville, SC 29605-4620
Phone (864) 233-5722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20111013000461 SC Practitioner - Ophthalmology 1951471275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Carolina School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 Doctors Dr
Greenville, SC 29605-5608
Phone 86426933332271

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26156ALMDOphthalmology Physician
33461SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Consultants of Carolina, PA Ophthalmology CurrentSince Jul 25, 2011 Accepting new patients
Southern Eye Associates of South Carolina, PA Ophthalmology CurrentSince Aug 2, 2021 Accepting new patients
Southern Eye Associates of SC, PA Ophthalmology CurrentSince Aug 2, 2021 Accepting new patients
Southern Eye Associates of SC, PA Ophthalmology Past Accepting new patients

Locations

161 Thomas Green Blvd
Clemson, SC 29631
Phone (864) 269-3333

110 Mall Connector Rd
Ste 101
Greenville, SC 29607
Phone (864) 269-3333

1126 Grove Rd
Greenville, SC 29605
Phone (864) 233-5722

113 Doctors Dr
Greenville, SC 29605
Phone (864) 269-3333

100 Physicians Dr
Greer, SC 29650
Phone (864) 269-3333

100 Allawood Ct
Ste 102
Simpsonville, SC 29681

480 N Church St
Spartanburg, SC 29303
Phone (864) 233-5722

Interoperability endpoints

  • Direct secure messaging: pgoodwin@southerneye.emadirect.md

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1649488594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054620",
            "telephone_number": "864-233-5722",
            "fax_number": "864-233-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055608",
            "telephone_number": "864-269-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "26156",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "33461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.