Individual provider Active NPI

Eric Goedecke, D.O.

  • Emergency Medicine Physician
  • Greenville, SC
National Provider Identifier
1811964265
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
90105 Issued in SC
Practice address
701 Grove Rd FL 1
Greenville, SC 29605-4210
Phone
(864) 455-7899
Fax
(864) 455-5474
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 221572 MA
Emergency Medicine Physician 207P00000X 90105 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 1
Greenville, SC 29605-4210

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697

Other practice location 1

55 Lake Ave N
Department of Emergency Medicine
Worcester, MA 01655-0002
Phone (508) 856-5426

Other identifiers 1

IdentifierTypeStateIssuer
2108615MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, SC, OR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20050909000230 MA Practitioner - Emergency Medicine 9133151202 Reassigns benefits to 1 organization
I20250818002551 SC Practitioner - Emergency Medicine 9133151202 Reassigns benefits to 1 organization
I20251104004659 OR Practitioner - Emergency Medicine 9133151202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

701 Grove Rd
Greenville, SC 29605-4210
Phone (864) 797-7100

Hospital & facility affiliations

  • Milford Regional Medical Center Hospital, Milford, MA, CCN 220090
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037

Merit-based Incentive Payment System (MIPS)

Final score
93.61 of 100Reported as group
Quality
85.22
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221572MAMDEmergency Medicine Physician
90105SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 4, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 4, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Oct 1, 2025 Accepting new patients
Orion Emergency Services, Inc. Emergency Medicine CurrentSince Aug 1, 2005 Accepting new patients
Umass Memorial Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

701 Grove Rd
Fl 1
Greenville, SC 29605
Phone (864) 455-7899

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: egoedecke859980@direct.ghs.myhfn.org

Organizations & group practices 5

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 5

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1811964265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7899",
            "fax_number": "864-455-5474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_2": "Department of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-856-5426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOEDECKE",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "221572",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "90105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2108615",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.