Brett W. Goudie, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

RI13511 Issued in RI

Practice address

1 Hoppin St
Coro Building
Providence, RI 02903-4141

Phone

(401) 444-4612

Fax

(401) 793-8831

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in RI, MA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgoudie6915@brownhealth.medalliesdirect.net

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.

• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643

  MA

  Medicare reassignment NPD
• Newport Hospital

  • Cardiology Technician
  • Newport, RI
  • NPI 1265652358
  Medicare reassignment NPD
• Rhode Island Hospital

  • Pediatrics Physician
  • Providence, RI
  • NPI 1861420333
  Medicare reassignment NPD
• Silver Spring Health Care Management, Inc

  • Cardiovascular Disease Physician
  • Wakefield, RI
  • NPI 1528152691

  Pediatric Cardiology

  Medicare reassignment NPD
• Affinity Physicians LLC

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1053038471
  NPD
• Kent County Memorial Hospital

  • Rehabilitation Hospital Unit
  • Warwick, RI
  • NPI 1023017944
  NPD
• Kent County Memorial Hospital

  • General Acute Care Hospital
  • Warwick, RI
  • NPI 1386643294
  NPD
• Lifespan Corporation

  • Children's Rehabilitation Hospital
  • Providence, RI
  • NPI 1790221232
  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• Newport Hospital

  • Obstetrics & Gynecology Physician
  • Newport, RI
  • NPI 1063632180
  NPD
• Newport Hospital

  • Emergency Medicine Physician
  • Newport, RI
  • NPI 1356441562
  NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1679627798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "HASBRO 122",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4612",
            "fax_number": "401-793-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST",
            "address_2": "CORO BUILDING",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141",
            "telephone_number": "401-444-4612",
            "fax_number": "401-793-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDIE",
        "first_name": "BRETT",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "DE",
            "license": "C10008082",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MD",
            "license": "D0068007",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD429590",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "RI",
            "license": "RI13511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109592",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679627798",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110510",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101712508",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Got, MD
• Gotham Per Diem, Inc.
• Alexandra Lauren Gottier, FNP-C
• Michael Gottlieb, M.D.
• Claire Constance Goucher, OD
• David Goudreau, CRNA
• Walter J Goula, MD
• Lauren Lee Gould, RD
• Molly Gould, OTD OTR
• Arsen Gourjian

• Pediatric Cardiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Pediatric Cardiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; 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.

Verify at the official NPI Registry.