Theodore Avram Goodman, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G35973 Issued in CA

Practice address

7700 Folsom Blvd
Sacramento, CA 95826

Phone

(916) 386-3645

Fax

(916) 386-3050

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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

Practice roles

Locations

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.

• Theodore a. Goodman MD Inc.

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1174618748
  Medicare reassignment NPD Authorized official
• Golden State Therapy Center

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Lodi, CA
  • NPI 1720085343
  NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1841386471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262608",
            "telephone_number": "916-386-3645",
            "fax_number": "916-386-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95826",
            "telephone_number": "916-386-3645",
            "fax_number": "916-386-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "THEODORE",
        "middle_name": "AVRAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G35973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G35973",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Goodman
• Kimberly Michelle Goodman
• Roschelle Roina Goodman
• Shaniece Shirell Goodman
• Stephanie Goodman, MT-BC, NICU-MT
• Caitlin Goodmanson
• James Edgar Goodnight Jr., M.D.
• Cynthia Goodnough
• Thomas M. Goodnow, CRNA
• John Ethan Goodrich, MD

• Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.