Individual provider Active NPI

John A. Goeders, M.D.

  • Anesthesiology Physician
  • Naperville, IL
National Provider Identifier
1730345976
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036-121210 Issued in IL
Practice address
801 S Washington St
Naperville, IL 60540-7430
Phone
(630) 355-0450
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-121210 IL Primary
Interventional Pain Medicine Physician 208VP0014X 036-121210 IL

Addresses

Primary practice location

801 S Washington St
Naperville, IL 60540-7430

Mailing address

387 Shuman Blvd
Suite 240W
Naperville, IL 60563-8450
Phone (630) 355-0450

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080821000483 IL Practitioner - Anesthesiology 1951476175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Valley Anesthesiologists LTDGroup PAC ID 6305747890, 62 clinicians

Practice addresses (Care Compare)

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-3000

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-121210ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Valley Anesthesiologists, LTD. Anesthesiology CurrentSince Aug 16, 2008 Accepting new patients
Chicago Area Partners in Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

387 Shuman Blvd
Ste 240W
Naperville, IL 60563

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1730345976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 SHUMAN BLVD",
            "address_2": "SUITE 240W",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638450",
            "telephone_number": "630-355-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407430",
            "telephone_number": "630-355-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDERS",
        "first_name": "JOHN",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-121210",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036-121210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.