Michael Joseph Gootee, MD

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

License

036090454 Issued in IL

Practice address

420 NE Glen Oak Ave
Peoria, IL 61603-3105

Phone

(309) 655-4180

Fax

(309) 655-3948

NPI assigned

Feb 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Midwest Hearing Center

  • Hearing and Speech Clinic/Center
  • Peoria, IL
  • NPI 1518994714
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1720050982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033105",
            "telephone_number": "309-655-4180",
            "fax_number": "309-655-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033105",
            "telephone_number": "309-655-4180",
            "fax_number": "309-655-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOTEE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "IL",
            "license": "036090454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090454",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Mary Goodman, BSW, MSW, SSW
• Jana Lynn Goodwin, APP
• Jamie Goodyear, OTR/L
• Harmony Goorley, LPCC
• Thomas Albert Goossens, LCSW
• Meera Gopu, MD
• Emma Gorden, OTR/L
• Roberto Gordillo Perez, MD
• Rujuta Gore
• David L Gorenz, M.D.

• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.