NPIMap

Individual provider Active NPI

Roger R. Good, M.D.

  • Radiation Oncology Physician
  • Columbia, MO
National Provider Identifier
1881652915
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
L0217 Issued in TX
Practice address
105 N Keene St
Suite 101
Columbia, MO 65201-8131
Phone
(573) 499-9995
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X L0217 TX Primary

Addresses

Primary practice location

105 N Keene St
Suite 101
Columbia, MO 65201-8131

Mailing address

PO Box 951339
Dallas, TX 75395-1339
Phone (940) 270-5000

Other identifiers 1

IdentifierTypeStateIssuer
148449501MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rgood20807@direct.monroeclinic.org Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220520001360 NE Practitioner - Radiation Oncology 8628020534 Reassigns benefits to 1 organization
I20260611002865 CO Practitioner - Radiation Oncology 8628020534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

340 Exempla Cir
300 Lafayette Clinic Neurosurgery
Lafayette, CO 80026-3384
Phone (303) 673-1390

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116
  • Saint Joseph Hospital Hospital, Denver, CO, CCN 060028
  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • Denver Health & Hospital Authority Hospital, Denver, CO, CCN 060011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1051WIMDGenetic Counselor (M.S.)
L0217TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Feb 18, 2022 Accepting new patients
Corinth Nuclear Imaging Resource PLLC PastSince Jul 25, 2006 Accepting new patients
Uvalde County Hospital Authority PastSince Nov 16, 2014 Accepting new patients
Intermountain Medical Group Denver, LLC Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1881652915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951339",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753951339",
            "telephone_number": "940-270-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST",
            "address_2": "SUITE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-499-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "ROGER",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "L0217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148449501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgood20807@direct.monroeclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rgood20807@direct.monroeclinic.org",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.