Individual provider Active NPI

David Goodman, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Carson, CO
National Provider Identifier
1700284221
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001355 Issued in GA
Practice address
1650 Cochrane Cir
Fort Carson, CO 80913-4613
Phone
(719) 526-7000
NPI assigned
Dec 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X POD001355 GA Primary

Addresses

Primary practice location

1650 Cochrane Cir
Fort Carson, CO 80913-4613

Mailing address

2005 Rock Ave
Fayetteville, NC 28303-7013
Phone (661) 549-8770

Other practice location 1

2817 Reilly St
Fort Bragg, NC 28310-7324
Phone (910) 907-6784

Other practice location 2

6600 Van Aalst Blvd
Fort Benning, GA 31905-2102
Phone (762) 408-1375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240627002170 MD Practitioner - Podiatry 6901160274 Reassigns benefits to 1 organization
I20240627002294 DC Practitioner - Podiatry 6901160274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Maryland Foot and Ankle LLCGroup PAC ID 9830198928, 4 clinicians

Practice addresses (Care Compare)

12070 Old Line Ctr
Suite 110
Waldorf, MD 20602-2503
Phone (301) 843-9581

9135 Piscataway Rd
Suite 235
Clinton, MD 20735-2572
Phone (301) 868-3899

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue50
Removal of skin lesions1-10
Removal of nail tissue1877
Removal or shaving of skin growth996
Skin biopsy19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Maryland Foot and Ankle LLC Foot & Ankle Surgery CurrentSince Jul 1, 2024 Accepting new patients

Locations

23415 Three Notch Rd
Ste 2054
California, MD 20619
Phone (301) 690-6044

9135 Piscataway Rd
Ste 235
Clinton, MD 20735
Phone (301) 868-8291

12070 Old Line Ctr
Ste 110
Waldorf, MD 20602
Phone (301) 638-0021

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": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1700284221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ROCK AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037013",
            "telephone_number": "661-549-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-526-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Reilly St",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283107324",
            "country_code": "US",
            "telephone_number": "910-907-6784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 Van Aalst Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Benning",
            "state": "GA",
            "postal_code": "319052102",
            "country_code": "US",
            "telephone_number": "762-408-1375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-16",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.