Active NPI
Sandra Beth Goodman, M.D.
- Reproductive Endocrinology Physician
- Tampa, FL
National Provider Identifier
1679568703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reproductive Endocrinology Physician
- License
- ME79728
- Practice address
- 5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126 - Phone
- (813) 914-7304
- Fax
- (813) 676-8812
- NPI assigned
- Sep 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | ME79728 | FL | Primary |
| Reproductive Endocrinology Physician | 207VE0102X | 60592 | MA | |
| Reproductive Endocrinology Physician | 207VE0102X | 19268 | DC | |
| Reproductive Endocrinology Physician | 207VE0102X | D42657 | MD | |
| Reproductive Endocrinology Physician | 207VE0102X | 51258 | VA |
Addresses
Primary practice location
5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126
Mailing address
5245 E Fletcher Ave
Suite 1
Tampa, FL 33617-1126
Phone (813) 914-7304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110908002121 | FL | Practitioner - Obstetrics/Gynecology | 4981873858 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19268 | DC | MD | Reproductive Endocrinology Physician |
| 60592 | MA | MD | Reproductive Endocrinology Physician |
| D42657 | MD | MD | Reproductive Endocrinology Physician |
| 51258 | VA | MD | Reproductive Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RMG Ivf/ Surgery Center LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ambulatory Fertility Facility
- Tampa, FL
- NPI 1255326302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1679568703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5245 E FLETCHER AVE",
"address_2": "SUITE 1",
"city": "TAMPA",
"state": "FL",
"postal_code": "336171126",
"telephone_number": "813-914-7304",
"fax_number": "813-676-8812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5245 E FLETCHER AVE",
"address_2": "SUITE 1",
"city": "TAMPA",
"state": "FL",
"postal_code": "336171126",
"telephone_number": "813-914-7304",
"fax_number": "813-676-8812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "SANDRA",
"middle_name": "BETH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-14",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "FL",
"license": "ME79728",
"primary": true
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "MA",
"license": "60592",
"primary": false
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "DC",
"license": "19268",
"primary": false
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "MD",
"license": "D42657",
"primary": false
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "VA",
"license": "51258",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.