Individual provider Active NPI

John-Philip Goodman, DPT

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1669135331
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047961 Issued in NY
Practice address
171 Intrepid LN
Syracuse, NY 13205-2548
Phone
(315) 437-4689
NPI assigned
Oct 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 047961 NY Primary

Addresses

Primary practice location

171 Intrepid LN
Syracuse, NY 13205-2548

Mailing address

325 McClennan Dr
Fayetteville, NY 13066-1238
Phone (315) 399-3805

Other practice location 1

225 Wilkinson St
Syracuse, NY 13204-2456
Phone (315) 399-3805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122000087 NY Practitioner - Physical Therapist in Private Practice 1850743378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of Ny Upstate Medical University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Home Stretch Physical Therapy PCGroup PAC ID 4981996923, 14 clinicians

Practice addresses (Care Compare)

Syracuse, NY 13215
Phone (315) 569-9308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Home Stretch Physical Therapy , P.C. Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Accent Physical Therapy, P.C. CurrentSince Nov 21, 2023 Accepting new patients
The Network for Children'S Speech, Occupational and Physical Therapy PastSince Oct 24, 2021 Accepting new patients

Locations

6620 Fly Rd
Ste 102
East Syracuse, NY 13057
Phone (315) 399-4770

Organizations & group practices 3

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": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1669135331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MCCLENNAN DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661238",
            "telephone_number": "315-399-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052548",
            "telephone_number": "315-437-4689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Wilkinson St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132042456",
            "country_code": "US",
            "telephone_number": "315-399-3805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "JOHN-PHILIP",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.

Verify at the official NPI Registry.