MIKAELA R GOODWATER FNP-C
NPI 1154143089
Nurse Practitioner - Family in Canon City, CO

Active since October 30, 2024PECOS EnrolledAccepts Medicare Assignment
715 S 9TH ST, CANON CITY, CO 81212(719) 269-8820 Get Directions Write a Review

NPPES record last updated: February 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 7, 2025, Nov 4, 2024 (2 updates tracked since 2024).

About Mikaela R Goodwater Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIKAELA R GOODWATER FNP-C (NPI 1154143089) is an individual family provider in Canon City, Colorado, licensed in Colorado (APN.1000278-NP) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1154143089
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMIKAELA R GOODWATERCredential: FNP-C
Location Address715 S 9TH STCanon City, CO 81212-4911
Mailing Address715 S 9th StCanon City, CO 81212-4911 · (719) 269-8820
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 30, 2024
Last NPPES UpdateFebruary 7, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2025
NPI 1154143089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in CO · APN.1000278-NP
715 S 9TH ST, Canon City, CO 81212

Other Names 1

Former Name (1)Mikaela R Carlock

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mikaela R Goodwater Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072041284
PECOS Enrollment IDI20250115000914
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 81212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
715 S 9TH ST
CANON CITY, CO 81212
Nurse Practitioner (Family)
715 S 9TH ST
CANON CITY, CO 81212
Nurse Practitioner
715 S 9TH ST
CANON CITY, CO 81212
Nurse Practitioner (Family)
715 S 9TH ST
CANON CITY, CO 81212
Nurse Practitioner
715 S 9TH ST
CANON CITY, CO 81212
Nurse Practitioner (Family)
715 S 9TH ST
CANON CITY, CO 81212
Nurse Practitioner (Family)
715 S 9TH ST
CANON CITY, CO 81212
Family Medicine
715 S 9TH ST
CANON CITY, CO 81212

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mikaela Goodwater's NPI number?

The NPI number for Mikaela Goodwater is 1154143089. It was assigned to this individual provider in the NPPES registry on October 30, 2024. The provider is also known as Mikaela R Carlock.

Where is Mikaela Goodwater located?

Mikaela Goodwater practices at 715 S 9th St, Canon City, CO 81212. The listed phone number is (719) 269-8820.

What is Mikaela Goodwater's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mikaela Goodwater enrolled in Medicare?

Yes. Mikaela Goodwater is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mikaela Goodwater was last updated on February 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.