Stefanie A Goodrich, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1875 Issued in MA

Practice address

100 Martin Luther King Jr Blvd
Worcester, MA 01680-1209

Phone

(508) 754-3823

Fax

(508) 753-0151

NPI assigned

Nov 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Worcester Dermatology Associates, P.C.Group PAC ID 4587613369, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.39 of 100Reported as individual

Quality

86.79

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Worcester Dermatology Associates, P.C.

  • Specialist
  • Worcester, MA
  • NPI 1144211681
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1689665135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARTIN LUTHER KING JR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016801209",
            "telephone_number": "508-754-3823",
            "fax_number": "508-753-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARTIN LUTHER KING JR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016801209",
            "telephone_number": "508-754-3823",
            "fax_number": "508-753-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "STEFANIE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2021-02-13",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "1875",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA1875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese Georgette Goodchild, M.S., CCC-SLP, M.E.D
• Michael A Goodfriend, MD
• Goodhire Healthcare Staffing, Inc
• Meagan Elizabeth Goodier, NP
• David James Goodrich II
• Stephanie Goodrum, MSW
• Lindsay K Goodwin
• Rebecca Leupo Goodwin
• Lavanya Gopinath
• Rachel Mary Gora, NP

• Physician Assistant in Worcester, MA
• Providers in Worcester, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; 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.
• 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.