Individual provider Active NPI

Madeline Streitz Pokorney Goeden, M.D.

  • Pediatrics Physician
  • Minnetonka, MN
National Provider Identifier
1942645601
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60311 Issued in MN
Practice address
14001 Ridgedale Dr
Suite 100
Minnetonka, MN 55305-1753
Phone
(952) 473-7908
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60311 MN Primary

Addresses

Primary practice location

14001 Ridgedale Dr
Suite 100
Minnetonka, MN 55305-1753

Mailing address

14001 Ridgedale Dr
Suite 100
Minnetonka, MN 55305-1753
Phone (952) 473-7908

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160413000955 MN Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4385942077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60311MNMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1942645601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "SUITE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051753",
            "telephone_number": "952-473-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "SUITE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051753",
            "telephone_number": "952-473-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDEN",
        "first_name": "MADELINE",
        "middle_name": "STREITZ POKORNEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "60311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.