Individual provider Active NPI

Leslie L Goodavish, MMS PAC

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1730141987
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1933-23 Issued in WI
Practice address
4602 Eastpark Blvd
Madison, WI 53718-2002
Phone
(608) 263-8820
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MED-PAC-LIC-79429 MT
Physician Assistant 363A00000X 1933-23 WI Primary

Addresses

Primary practice location

4602 Eastpark Blvd
Madison, WI 53718-2002

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 829-5485

Other practice location 1

7929 Oak View Drive
Madison, WI 53719
Phone (608) 469-0232

Other practice location 2

7929 Oak View Drive
Madison, WI 53719
Phone (608) 469-0232

Other names 1

  • Leslie L Standorf Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgoodavish32915@direct.uwhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20060405000239 WI Practitioner - Physician Assistant 3678581410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Wisconsin Medical Foundation IncGroup PAC ID 6608785464, 2,537 clinicians

Practice addresses (Care Compare)

2402 Winnebago St
Madison, WI 53704-5341
Phone (608) 287-2770

4602 Eastpark Blvd
Madison, WI 53718-2002
Phone (608) 440-6400

500 Midland CT
Janesville, WI 53546-2341
Phone (608) 916-2600

5543 E Cheryl Pkwy
Fitchburg, WI 53711-5376
Phone (608) 274-5300

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

621 Science Dr
Madison, WI 53711-1074
Phone (608) 263-8400

7102 Mineral Point Rd
Madison, WI 53717-1706
Phone (608) 828-7603

Hospital & facility affiliations

  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MED-PAC-LIC-79429MTMDPhysician Assistant
1933-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1730141987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-829-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 EASTPARK BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537182002",
            "telephone_number": "608-263-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7929 Oak View Drive",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "53719",
            "country_code": "US",
            "telephone_number": "608-469-0232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7929 Oak View Drive",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "53719",
            "country_code": "US",
            "telephone_number": "608-469-0232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODAVISH",
        "first_name": "LESLIE",
        "middle_name": "L",
        "credential": "MMS PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-79429",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1933-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgoodavish32915@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "4602 Eastpark Blvd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537182002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "STANDORF",
            "middle_name": "L",
            "credential": "MMS PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.