| Kevin Goodwin, | |
|
110 W 6th St, Oswego, NY 13126-2507 | |
| (315) 349-5733 | |
| Not Available |
| Full Name | Kevin Goodwin |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 9 Years |
| Location | 110 W 6th St, Oswego, New York |
| 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 |
|---|---|---|---|
| 1952763989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 711452 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Mountainside Hospital Inc | Jasper, GA | Hospital |
| Memorial University Medical Center | Savannah, GA | Hospital |
| Northside Hospital | Atlanta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fortis Health, Llc | 8325446305 | 13 |
| Se Georgia Anesthesia, Llc | 8426466137 | 106 |
| Entity Name | Sentry Anesthesia Management, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134544794 PECOS PAC ID: 9436372323 Enrollment ID: O20140521002571 |
| Entity Name | Coastal Ambulatory Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750753786 PECOS PAC ID: 1052613023 Enrollment ID: O20160107001775 |
| Entity Name | Ams Southeast Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487107157 PECOS PAC ID: 3870880792 Enrollment ID: O20160921000551 |
| Entity Name | Mak Anesthesia Holdings, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
| Entity Name | Gi Anesthesia Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326569187 PECOS PAC ID: 0446516769 Enrollment ID: O20171102000283 |
| Entity Name | Mak Anesthesia Northside Affiliates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609390103 PECOS PAC ID: 7315203718 Enrollment ID: O20171116002499 |
| Entity Name | Piedmont Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700474244 PECOS PAC ID: 2163837972 Enrollment ID: O20210208002823 |
| Entity Name | Se Georgia Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518542919 PECOS PAC ID: 8426466137 Enrollment ID: O20210419001856 |
| Entity Name | Fortis Health, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659960276 PECOS PAC ID: 8325446305 Enrollment ID: O20211005002270 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Goodwin, 252 East 9th St, Oswego, NY 13126 Ph: (334) 332-7326 | Kevin Goodwin, 110 W 6th St, Oswego, NY 13126-2507 Ph: (315) 349-5733 |
Mrs. Amie Ellene Johnson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5511 | |
Demir Ahmetovic, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5511 | |
Kathy Mills, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 110 West Sixth St, Oswego, NY 13126 Phone: 315-349-5511 Fax: 315-349-5785 | |
Mr. John Joseph Meade, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5511 Fax: 315-349-5785 | |
Manolito Ramirez, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5598 | |
Charrisse M Morada, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5511 Fax: 315-349-5785 |