NPIMap

Individual provider Active NPI

Brian Michael Goodman, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Greenwood, SC
National Provider Identifier
1740453893
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
82135 Issued in SC
Practice address
1506 Spring St
Greenwood, SC 29646-4071
Phone
(864) 725-7900
Fax
(864) 725-7910
NPI assigned
Apr 9, 2008
Last updated
May 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD428829 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD428829 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 27566 WV
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 82135 SC Primary

Addresses

Primary practice location

1506 Spring St
Greenwood, SC 29646-4071

Mailing address

629 Main St
Wheeling, WV 26003-2525

Other practice location 1

1 Medical Park
Wheeling, WV 26003-6379
Phone (304) 243-8375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190417002523 SC Practitioner - Thoracic Surgery 2163614512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Vermont College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

1506 Spring St
Greenwood, SC 29646-4071
Phone (864) 725-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD428829PAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
82135SCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
27566WVMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince May 1, 2019 Accepting new patients
Self Medical Group CurrentSince May 1, 2019 Accepting new patients
Self Medical Group Surgery Current Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

105 Vinecrest Ct
#1000
Greenwood, SC 29646
Phone (864) 227-5240

1506 Spring St
Greenwood, SC 29646
Phone (864) 227-3117

421 Epting Ave
Greenwood, SC 29646
Phone (864) 227-6818

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1740453893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 MAIN ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464071",
            "telephone_number": "864-725-7900",
            "fax_number": "864-725-7910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Park",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "WV",
            "postal_code": "260036379",
            "country_code": "US",
            "telephone_number": "304-243-8375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD428829",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD428829",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WV",
            "license": "27566",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "82135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.