Individual provider Active NPI

Willie Henry Goffney Jr., MD

  • Surgical Oncology Physician
  • Long Beach, CA
National Provider Identifier
1679776074
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
G52590 Issued in CA
Practice address
3300 E. South St. Suite 201
Long Beach, CA 90805
Phone
(562) 531-9272
Fax
(562) 408-0346
NPI assigned
Jun 6, 2007
Last updated
Aug 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X G52590 CA Primary

Addresses

Primary practice location

3300 E. South St. Suite 201
Long Beach, CA 90805

Mailing address

3300 E. South St. Suite 201
Long Beach, CA 90805
Phone (562) 531-9272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150930000803 CA Practitioner - Surgical OncologyPractitioner - General Surgery 4688752264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Harvard Medical School, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3300 E S St
Suite 201
Lakewood, CA 90805-4588
Phone (562) 531-9272

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue27
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G52590CAMDSurgical Oncology Physician

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

Hospital & facility affiliations 5

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1679776074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E. SOUTH ST. SUITE 201",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90805",
            "telephone_number": "562-531-9272",
            "fax_number": "562-408-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E. SOUTH ST. SUITE 201",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90805",
            "telephone_number": "562-531-9272",
            "fax_number": "562-408-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFFNEY",
        "first_name": "WILLIE",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "G52590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.