Mark P Goldman, PH. D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

22476 Issued in TX

Practice address

222 Sidney Baker St S
Suite 500
Kerrville, TX 78028-5994

Phone

(830) 895-7675

Fax

(830) 896-9340

NPI assigned

Aug 29, 2006

Last updated

Jul 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark P. Goldman, P.C.

  • Clinical Psychologist
  • Kerrville, TX
  • NPI 1497067169
  Medicare reassignment NPD Authorized official
• Phoenix Medical Associates

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Kerrville, TX
  • NPI 1790736239
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1740399328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291993",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780291993",
            "telephone_number": "830-895-7675",
            "fax_number": "830-896-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SIDNEY BAKER ST S",
            "address_2": "SUITE 500",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780285994",
            "telephone_number": "830-895-7675",
            "fax_number": "830-896-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "22476",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "22476",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00H51R",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIPS",
            "identifier": "098724001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098724001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael M Gnuechtel, D.O.
• Jill Ann Godsey, APN,CNS
• Anna Michelle Mabesa Gogorza
• Vedant Chimanlal Gohil, DDS
• Dilana Lee Gohlke, SLP
• Daniel Gomez, DDS
• Estella Gonzalez, LVN
• Kendra Renee Gonzalez, MS, CCC-SLP
• Terria Shavon Goodloe, LVN
• Jason Goodrum, MD

• Clinical Neuropsychologist in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.