Individual provider Active NPI

Benjamin Ashby Goodrum, CNM, FNP

  • Midwife
  • Berkeley, CA
National Provider Identifier
1861893414
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
CNM236316 Issued in CA
Practice address
2450 Ashby Ave
Berkeley, CA 94705-2067
Phone
(510) 204-3977
NPI assigned
Sep 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201406326NP-PP OR
Advanced Practice Midwife 367A00000X F002184-01 NY
Midwife 176B00000X CNM236316 CA Primary

Addresses

Primary practice location

2450 Ashby Ave
Berkeley, CA 94705-2067

Mailing address

PO Box 276950
Sacramento, CA 95827-6950

Other practice location 1

530 NW 27th St
Corvallis, OR 97330-5223
Phone (541) 766-6835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230424000319 NY Practitioner - Certified Nurse Midwife (CNM) 4981825361 Reassigns benefits to 2 organizations
I20250612002399 CA Practitioner - Certified Nurse Midwife (CNM) 4981825361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (510) 204-4444

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
002184NYMDMarriage & Family Therapist
CNM236316CAMDMidwife
201406326NP-PPORMDFamily Nurse Practitioner
F002184-01NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Sep 10, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 21, 2025 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Feb 1, 2023 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Montefiore Medical Center CurrentSince Sep 10, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Aug 12, 2025 Accepting new patients
Permanente Medical Group Inc CurrentSince Aug 12, 2025 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Apr 21, 2025 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Feb 1, 2023 Accepting new patients
Lawrence Medical Associates, PC Current Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations (25 of 37)

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2238 Geary Blvd
San Francisco, CA 94115
Phone (415) 833-2200

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

Interoperability endpoints

  • Direct secure messaging: bgoodrum735496@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1861893414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276950",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ASHBY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052067",
            "telephone_number": "510-204-3977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NW 27th St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305223",
            "country_code": "US",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODRUM",
        "first_name": "BENJAMIN ASHBY",
        "credential": "CNM, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201406326NP-PP",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F002184-01",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "CNM236316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.