| Dale A Goodman, MD | |
|
1007 Lincolnway, La Porte, IN 46350-3201 | |
| (219) 326-1234 | |
| Not Available |
| Full Name | Dale A Goodman |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 37 Years |
| Location | 1007 Lincolnway, La Porte, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518052158 | NPI | - | NPPES |
| 000000191669 | Other | IN | ANTHEM PROVIDER NUMBER |
| 050027208 | Other | IN | RAILROAD PROVIDER NUMBER |
| 100165370A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 01041200 (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Franciscan St Anthony Health - Michigan City | Michigan city, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| La Porte County Anesthesia Associates, Llc | 4688633241 | 18 |
| Entity Name | La Porte County Anesthesia Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477553634 PECOS PAC ID: 4688633241 Enrollment ID: O20041008000231 |
| Entity Name | Anesthesia Associates Of Laporte Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235455429 PECOS PAC ID: 3779614508 Enrollment ID: O20100623000427 |
| Mailing Address | Practice Location Address |
|---|---|
| Dale A Goodman, MD 800 Lincolnway, Suite 301, La Porte, IN 46350-3438 Ph: (219) 324-2229 | Dale A Goodman, MD 1007 Lincolnway, La Porte, IN 46350-3201 Ph: (219) 326-1234 |
Dr. Terry Christopher Easton, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1331 State St, La Porte, IN 46350 Phone: 219-326-1234 Fax: 317-324-1012 | |
Jeremiah L Ashe, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 974 S Redbud Dr, La Porte, IN 46350 Phone: 317-679-1792 | |
Jana Dimce Dukleski, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1007 Lincolnway, La Porte, IN 46350 Phone: 219-326-1234 | |
Richard J Gnaedinger, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1007 Lincolnway, La Porte, IN 46350 Phone: 219-326-1234 | |
Linda S Sirugo, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 1007 Lincolnway, La Porte, IN 46350 Phone: 219-324-2229 Fax: 219-324-2229 | |
William E. Wolf Iii, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1007 Lincolnway, La Porte, IN 46350 Phone: 219-324-2229 Fax: 219-324-2229 |