DR. KENNETH GOODMAN M.D. NPI 1174539357

NPI Information

NPI: 1174539357
Provider Name: DR. KENNETH GOODMAN, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
100 PORT WASHINGTON BLVD
ROSLYN, NY
ZIP 11576
Phone: (516) 562-6510
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DR. Kenneth Goodman, M.D. is a diagnostic radiology radiology in Roslyn, NY. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Kenneth Goodman, M.D. NPI is 1174539357. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 PORT WASHINGTON BLVD
ROSLYN, NY
ZIP 11576-353
Phone: (516) 562-6510

The NPI 1174539357 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 11/19/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	117490	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C06116	MEDICARE UPIN	NEW YORK
2	16A301	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK	MEDICARE PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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