Paul Goodman

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D79841 Issued in MD

Practice address

5711 Sarvis Ave
Suite 402
Riverdale, MD 20737-1394

Phone

(301) 277-4844

Fax

(301) 927-3221

NPI assigned

Apr 6, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Washington National Eye Center

  • Ophthalmology Physician
  • Washington, DC
  • NPI 1437175684
  Medicare reassignment NPD
• WHC Physician Group LLC

  • General Practice Physician
  • Washington, DC
  • NPI 1700154226
  Medicare reassignment NPD
• WHC Emerg Phys

  • Emergency Medical Services (Emergency Medicine) Physician
  • Washington, DC
  • NPI 1306260625
  NPD

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1932498482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 SARVIS AVE",
            "address_2": "SUITE 402",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371394",
            "telephone_number": "301-277-4844",
            "fax_number": "301-927-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5711 SARVIS AVE",
            "address_2": "SUITE 402",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371394",
            "telephone_number": "301-277-4844",
            "fax_number": "301-927-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D79841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "D79841",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reva Gill, MD
• Tifuh Glory Tenya
• Asaah Godlove
• Gofan Healthcare Service LLC
• Lourdes Gonzalez Aviles, M.D.
• Ekop Graham, FNP
• Jinmee Graham, ND, MPH
• Kimberly M Green, CSC-AD, RAC
• Benita Ceceilia Griffin, SLP.D., CCC-SLP
• Marisa N Gruber, BCBA, LBA

• Ophthalmology Physician in Riverdale, MD
• Providers in Riverdale, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.