DR. MARK GOODENOUGH DDS, MD
NPI 1154858033
Oral & Maxillofacial Surgery in Staten Island, NY

Q: What is Mark Goodenough's NPI number?

The NPI number for Mark Goodenough is 1154858033. It was assigned to this individual provider in the NPPES registry on May 22, 2017.

Q: What is Mark Goodenough's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Goodenough was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since May 22, 2017PECOS EnrolledAccepts Medicare Assignment

256C MASON AVE, STATEN ISLAND, NY 10305(718) 226-1251 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 26, 2024, Dec 6, 2023, Jul 24, 2023 and 2 more (5 updates tracked since 2017).

On this page

About Dr. Mark Goodenough Dds, Md NPPES

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

DR. MARK GOODENOUGH DDS, MD (NPI 1154858033) is an individual oral & maxillofacial surgery provider in Staten Island, New York, licensed in New York (063143) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, is affiliated with Maimonides Medical Center, and maintains a secondary practice location in Staten Island.

NPPES Registry Identity

NPI1154858033

Entity TypeIndividualMale

Primary Taxonomy204E00000X

Provider Legal NameDR. MARK GOODENOUGHCredential: DDS, MD

Location Address256C MASON AVEStaten Island, NY 10305-3408

Mailing Address256 Mason Ave # CStaten Island, NY 10305-3408 · (718) 226-1251

Phone(718) 226-1251

Sole ProprietorNo

Medical School CMSColumbia University College Of Dental MedicineGraduated 2017

Enumeration DateMay 22, 2017

Last NPPES UpdateJune 26, 20245 updates tracked since enumeration

NPPES CertifiedJune 26, 2024

✔ NPI 1154858033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code204E00000X

License✔ Licensed in NY · 063143

Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 311698 (NY)

256C MASON AVE, Staten Island, NY 10305

Open in Google Maps ↗

Secondary Practice Location 1

Location 11441 South Ave Ste 707Staten Island, NY 10314-3784 · Phone (718) 226-1251

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

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

Dr. Mark Goodenough Dds, Md 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 ID6800240433

PECOS Enrollment IDI20230929001677

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

24 services24 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Maimonides Medical Center

Acute Care Hospitals · Brooklyn, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330194

Location4802 Tenth AvenueBrooklyn, NY 11219 · Kings County

Emergency services Birthing friendly

Geisinger Medical Center

Acute Care Hospitals · Danville, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390006

Location100 North Academy AvenueDanville, PA 17822 · Montour County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 12

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

MS. CYNTHIA Y PRICE APRN,BC

Nurse Practitioner (Family)