Individual provider Active NPI

Gary Victor Goodmark, D.C.

  • Chiropractor
  • Wyckoff, NJ
National Provider Identifier
1952383739
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC01446 Issued in NJ
Practice address
615 Wyckoff Ave
Wyckoff, NJ 07481-1357
Phone
(201) 891-4121
Fax
(201) 891-6489
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC01446 NJ Primary

Addresses

Primary practice location

615 Wyckoff Ave
Wyckoff, NJ 07481-1357

Mailing address

615 Wyckoff Ave
Wyckoff, NJ 07481-1357
Phone (201) 891-4121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050121000144 NJ Practitioner - Chiropractic 8325097827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Columbia Institute Chiropractic, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

574 Franklin Ave
Franklin Lakes, NJ 07417-2511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC01446NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Goodmark DC PA Chiropractor CurrentSince Jan 1, 1989 Accepting new patients

Locations

574 Franklin Ave
Ste 4
Franklin Lks, NJ 07417
Phone (201) 891-4121

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952383739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WYCKOFF AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811357",
            "telephone_number": "201-891-4121",
            "fax_number": "201-891-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WYCKOFF AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811357",
            "telephone_number": "201-891-4121",
            "fax_number": "201-891-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMARK",
        "first_name": "GARY",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC01446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.