Gary M Goodman, MD

Primary specialty

Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X

License

102527 Issued in MO

Practice address

1 Childrens PL
Saint Louis, MO 63110-1002

Phone

(314) 454-2694

Fax

(314) 454-2515

NPI assigned

Aug 12, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in AZ, MO2 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 2

Specialty

Allergy/Immunology

Education

University of Michigan Medical School, 1981

Medicare assignment

May accept Medicare assignment

Group practices

Davis, Wright, Berdy, and Suffian, PCGroup PAC ID 9335110949, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gary.goodman.p1@direct.affiniahealthcare.nextgenshare.com
• Direct secure messaging: ggoodman154294@direct.carenet.org

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.

• Davis, Wright, Berdy, & Suffian PC

  • Allergy & Immunology Physician
  • Saint Louis, MO
  • NPI 1639110935
  Medicare reassignment Care Compare group NPD
• Allergy & Asthma Care of Sedona, LLC

  • Allergy & Immunology Physician
  • Cottonwood, AZ
  • NPI 1053500207
  Medicare reassignment NPD Authorized official
• Davis, Wright, Berdy & Suffian PC

  • Allergy & Immunology Physician
  • Washington, MO
  • NPI 1962687855
  NPD
• Affinia Healthcare

  • Dentist
  • Saint Louis, MO
  • NPI 1346634003
  NPD (past)
• Sedona Center for Complementary Medicine, Inc

  • Internal Medicine Physician
  • Sedona, AZ
  • NPI 1184726127
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1811999485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD",
            "address_2": "STE 129",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416812",
            "telephone_number": "314-569-1881",
            "fax_number": "314-569-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-2694",
            "fax_number": "314-454-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "GARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "102527",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MO",
            "license": "102527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204643001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherri Goodman-Ritchie, MSW,LCSW
• Alyssa Victoria Goodman, MD
• Bobby Joe Goodman, M.A.
• Bree Ann Goodman, MD
• David Earl Goodman, DDS
• Jared Vega Goodman, MD
• Joseph Goodman, RN
• Kyle Nicholas Goodman, MD, PHD
• Matthew Gerald Goodman
• Meaghan Cathleen Goodman, M.A., CCC-SLP

• Pediatric Allergy/Immunology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Allergy/Immunology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.