Peter Alexander Gooderham, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

A115849 Issued in CA

Practice address

300 Pasteur Dr
R209
Stanford, CA 94305-2200

Phone

(650) 725-5562

Fax

(650) 723-2815

NPI assigned

Apr 18, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  NPD (past)
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927

  Neurological Surgery

  NPD (past)

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1861782351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "address_2": "R209",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-725-5562",
            "fax_number": "650-723-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "address_2": "R209",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-725-5562",
            "fax_number": "650-723-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODERHAM",
        "first_name": "PETER",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A115849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Elena Gomez
• Rosan Gomperts, LCSW
• Raymond Gong, MD
• Christopher Gerard Gonzales, NP
• Alexander James Goodell, MD
• James Robert Goodman, MD, PHD
• Stuart Barry Goodman, MD, PHD
• Candida Laura Goodnough, MD, PHD
• Lawrence Henry Goodnough, MD
• Lawrence Tim Goodnough, MD

• Neurological Surgery Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.