Individual provider Active NPI

Sandra Beth Goodman, M.D.

  • Reproductive Endocrinology Physician
  • Tampa, FL
National Provider Identifier
1679568703
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
ME79728 Issued in FL
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

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110908002121 FL Practitioner - Obstetrics/Gynecology 4981873858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19268DCMDReproductive Endocrinology Physician
60592MAMDReproductive Endocrinology Physician
D42657MDMDReproductive Endocrinology Physician
51258VAMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.