Individual provider Active NPI

Ariel Lynne Goodman, OD

  • Optometrist
  • Portage, MI
National Provider Identifier
1790424067
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005644 Issued in MI
Practice address
3412 W Centre Ave
Portage, MI 49024-4624
Phone
(269) 329-5860
Fax
(269) 329-5865
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005644 MI Primary

Addresses

Primary practice location

3412 W Centre Ave
Portage, MI 49024-4624

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220802000132 MI Practitioner - Optometry 1658753025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalamazoo Ophthalmology PCGroup PAC ID 8628112380, 5 clinicians

Practice addresses (Care Compare)

3412 W Centre Ave
Portage, MI 49024-4624
Phone (269) 329-5860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Kalamazoo Ophthalmology PC Optometrist CurrentSince Aug 4, 2025 Accepting new patients

Locations

65 Columbia Ave E
Battle Creek, MI 49015
Phone (269) 342-0003

800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890

5465 Gull Rd
Kalamazoo, MI 49048
Phone (269) 349-7631

3412 W Centre Ave
Portage, MI 49024
Phone (269) 329-5860

6123 S Westnedge Ave
Portage, MI 49002
Phone (269) 327-7079

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: agoodman@kopc.intellechartdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1790424067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244624",
            "telephone_number": "269-329-5860",
            "fax_number": "269-329-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "ARIEL",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.