Elliot Goodenough, MD, PHD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD460791 Issued in PA

Practice address

1427 Vine St
Philadelphia, PA 19102-1031

Phone

(215) 762-2530

NPI assigned

May 30, 2015

Last updated

Apr 16, 2020By the provider in NPPES

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 PA

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

Specialty

Family Practice

Education

Jefferson Medical College of Thomas Jefferson University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drexel UniversityGroup PAC ID 5496664740, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: egoodenough18909@drexel.gardenplot.direct-ci.com
• Direct secure messaging: elliot.goodenough.p11@direct.ppncsnj.nextgenshare.com
• Direct secure messaging: elliot.goodenough.p3@direct.ppncsnj.nextgenshare.com
• Direct secure messaging: elliotgoodenough@nncc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Drexel University

  dba Drexel Psychology

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment Care Compare group NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881779866
  Medicare reassignment NPD
• Drexel University

  dba Pennsylvania Ear Institute

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  dba Drexel Center for Digestive Health

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1922103381
  NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1467776989
  NPD
• Public Health Mangement Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1912943457
  NPD
• Drexel University

  dba Drexel ID Partnership Clinic

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1538279732
  NPD (past)
• Drexel University

  dba Drexel OBGYN Center for Genetics & Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Philadelphia, PA
  • NPI 1629005152
  NPD (past)
• Public Health Management Corporation

  dba PHMC at Carson Valley

  • Federally Qualified Health Center (FQHC)
  • Flourtown, PA
  • NPI 1922535764
  NPD (past)

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

{
    "created_epoch": "1432944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1871973313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 VINE ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021031",
            "telephone_number": "215-762-2530",
            "fax_number": "215-762-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 VINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021031",
            "telephone_number": "215-762-2530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 W Lehigh Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191333148",
            "country_code": "US",
            "telephone_number": "215-279-9666",
            "fax_number": "215-279-9674",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 N 9th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191222028",
            "country_code": "US",
            "telephone_number": "215-765-6690",
            "fax_number": "215-765-6694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5675 N Front St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191202719",
            "country_code": "US",
            "telephone_number": "215-279-9666",
            "fax_number": "215-279-9674",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 North Broad Street 1st Floor",
            "address_2": "Suite D101",
            "address_purpose": "LOCATION",
            "city": "philadelphia",
            "state": "PA",
            "postal_code": "19140",
            "country_code": "US",
            "telephone_number": "215-731-7144",
            "fax_number": "267-765-2325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 S 9th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075125",
            "country_code": "US",
            "telephone_number": "215-592-4500",
            "fax_number": "215-592-4326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Callowhill St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191233658",
            "country_code": "US",
            "telephone_number": "215-825-8220",
            "fax_number": "267-765-2325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODENOUGH",
        "first_name": "ELLIOT",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-30",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD460791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103315777",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Behrokh Nikki Goodarzi, M.S
• Christine Marie Goodbody, M.D.
• Dana F Goode, PSY D
• Natalie Goode, PHARMD, BCACP
• Chanell-Nicole Gooden, MFT
• Evan Malcolm Goodfellow
• Goodheart Pharmacy
• Goodheart Pharmacy Inc
• Nichola Goodin, PA-C
• Anita Reinette Gooding, LSW

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.