Organization Active NPI

Bruce a Goodman, M.D., P.C.

  • Internal Medicine Physician
  • Newtown, PA
National Provider Identifier
1932268471
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD039676E Issued in PA
Legal business name
BRUCE A GOODMAN, M.D., P.C.
Practice address
790 Newtown Yardley Rd
Suite 420
Newtown, PA 18940-1748
Phone
(215) 860-2424
Fax
(215) 860-3044
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bruce A Goodman, M.D.NPI 1801892120
Title
President
Phone
(215) 598-3830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD039676E PA Primary

Addresses

Primary practice location

790 Newtown Yardley Rd
Suite 420
Newtown, PA 18940-1748

Mailing address

790 Newtown Yardley Rd
Suite 420
Newtown, PA 18940-1748
Phone (215) 860-2424

Other identifiers 5

IdentifierTypeStateIssuer
926337OtherPAIBC
6570340OtherPACIGNA
0873363001OtherPAKEYSTONE HEALTH PLAN EAST
1196960MedicaidPA
465902OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000383 PA Part B Supplier - Clinic/Group Practice 9436233343 Receives reassigned benefits from 1 practitioner
Practice locations: Newtown, PA

National Provider Directory

National Provider Directory

Locations

790 Newtown Yardley Rd
Ste 420
Newtown, PA 18940
Phone (215) 860-2424

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932268471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 NEWTOWN YARDLEY RD",
            "address_2": "SUITE 420",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401748",
            "telephone_number": "215-860-2424",
            "fax_number": "215-860-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NEWTOWN YARDLEY RD",
            "address_2": "SUITE 420",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401748",
            "telephone_number": "215-860-2424",
            "fax_number": "215-860-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE A GOODMAN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-598-3830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD039676E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "926337",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6570340",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0873363001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1196960",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "465902",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.