Amy D Goodman, CRNA is a medicare enrolled "Clinic/center" in San Luis Obispo, California. Her current practice location is
1375 Oakwood Ct, San Luis Obispo, California. You can reach out to her office (for appointments etc.) via phone at
(970) 379-5531.
Amy D Goodman is licensed to practice in California (license number 2974) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1942292701.
Provider's Profile
| Full Name | Amy D Goodman |
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| Gender | Female |
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| Speciality | Clinic/center |
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| Location | 1375 Oakwood Ct, San Luis Obispo, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1942292701
- Provider Enumeration Date: 08/18/2005
- Last Update Date: 06/01/2016
Medicare PECOS Information:
- PECOS PAC ID: 7810969714
- Enrollment ID: I20110826000020
Medical Identifiers
Medical identifiers for Amy D Goodman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942292701 | NPI | - | NPPES |
| 100503782 | Medicaid | NV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | CRNA000233 (Nevada) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | CRNA-183907 (Colorado) | Secondary |
| 261Q00000X | Clinic/center | 2974 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amy D Goodman allows following entities to bill medicare on her behalf.
| Entity Name | Amsurg San Luis Obispo Anesthesia Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164749842
PECOS PAC ID: 2466637525
Enrollment ID: O20110505000086 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy D Goodman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amy D Goodman, CRNA
Po Box 3037,
Pinedale, CA 93650-3037
Ph: (970) 379-5531 | Amy D Goodman, CRNA
1375 Oakwood Ct,
San Luis Obispo, CA 93401-5918
Ph: (970) 379-5531 |
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