KELLY A GOODMAN NP NPI 1639396914

NPI Details

Kelly A Goodman, NP is an adult health nurse practitioner in Bethesda, MD with 20 years of experience. Kelly A Goodman, NP NPI is 1639396914. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4701 SANGAMORE ROAD
SUITE 5207
BETHESDA, MD
ZIP 20816-529
Phone: (202) 684-7167
Fax: (240) 483-0441

The NPI 1639396914 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 CLIA number assigned to this NPI record is 21D2231407 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Insertion of needle into vein (3 years or older) (HCPCS:36410)
• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
• Insertion of needle into vein for collection of blood sample (HCPCS:36415)
• Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
• Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
• Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) (HCPCS:87811)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
• Annual depression screening, 15 minutes (HCPCS:G0444)
• Urinalysis, manual test (HCPCS:81002)
• Administration of vaccine (HCPCS:90471)
• Administration of pneumococcal vaccine (HCPCS:G0009)
• Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment (HCPCS:G0402)
• Automated urinalysis test (HCPCS:81003)
• Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
• Pneumococcal vaccine, 23-valent (HCPCS:90732)
• Removal of impacted ear wax (HCPCS:69210)
• New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
• Detection test by immunoassay with direct visual observation for influenza virus (HCPCS:87804)
• Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit (HCPCS:G0438)
• Sarscov2 vac 50mcg/0.25ml im (HCPCS:91306)
• Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free (HCPCS:90674)

The enumeration date for this NPI number is 4/19/2007 and was last updated on 7/14/2025.

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:

Other Identifiers

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