Individual provider Active NPI

McKaleigh B Goodale, PT

  • Physical Therapist
  • Sarasota, FL
National Provider Identifier
1801406400
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36086 Issued in FL
Practice address
2970 University Pkwy Ste 105
Sarasota, FL 34243-2401
Phone
(941) 360-1988
Fax
(941) 360-1998
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT36086 FL Primary

Addresses

Primary practice location

2970 University Pkwy Ste 105
Sarasota, FL 34243-2401

Mailing address

15208 17TH Ave E
Bradenton, FL 34212-8105
Phone (941) 780-5349

Other practice location 1

5968 Clark Center Ave
Sarasota, FL 34238-2715
Phone (941) 922-8200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200824000952 FL Practitioner - Physical Therapist in Private Practice 5193141083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Univ of Central Florida, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maxider CorporationGroup PAC ID 4385619154, 12 clinicians

Practice addresses (Care Compare)

2970 University Pkwy
Suite 105
Sarasota, FL 34243-2401
Phone 9413601988107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1801406400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15208 17TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342128105",
            "telephone_number": "941-780-5349",
            "fax_number": "941-360-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 UNIVERSITY PKWY STE 105",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432401",
            "telephone_number": "941-360-1988",
            "fax_number": "941-360-1998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5968 Clark Center Ave",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342382715",
            "country_code": "US",
            "telephone_number": "941-922-8200",
            "fax_number": "941-343-9402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODALE",
        "first_name": "MCKALEIGH",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.