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MICHAEL P GOODMAN M.D.
NPI 1174558407
Specialist in Davis, CA

Active since July 12, 2006Opted out of Medicare · through Apr 5, 2028
635 ANDERSON RD, SUITE 12B, DAVIS, CA 95616(530) 753-2787(530) 750-0221 Get Directions Write a Review

NPPES record last updated: July 28, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michael P Goodman M.d. NPPES

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

MICHAEL P GOODMAN M.D. (NPI 1174558407) is an individual specialist in Davis, California, licensed in California (C31721) and active in the NPI registry since July 2006. He has opted out of Medicare through April 5, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1174558407
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameMICHAEL P GOODMANCredential: M.D.
Location Address635 ANDERSON RD, SUITE 12BDavis, CA 95616-3505
Mailing Address635 Anderson Rd, Suite 12bDavis, CA 95616-3505 · (530) 753-2787 · Fax (530) 750-0221
Phone(530) 753-2787
Fax(530) 750-0221
Sole ProprietorYes
Enumeration DateJuly 12, 2006
Last NPPES UpdateJuly 28, 2008
✔ NPI 1174558407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · C31721
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
635 ANDERSON RD, Davis, CA 95616
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Other Identifiers 2

Medicare ID-Type UnspecifiedOOC317210CA · Medicare Provider Number
Medicare UPINA34680CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Michael P Goodman M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 5, 2016 through April 5, 2028.

Opt-Out Effective DateApril 5, 2016
Opt-Out In Effect ThroughApril 5, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

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

RONALD D COTTEREL MD
Family Medicine
635 ANDERSON RD, SUITE 12
DAVIS, CA 95616
Yolo County (530) 758-1122
CRYSTAL BLANKENSHIP M.D.
Family Medicine
635 ANDERSON RD, SUITE 10
DAVIS, CA 95616
Yolo County (530) 758-1122
SPECIALIZED ORTHOPEDIC SURGEONS
Specialist
635 ANDERSON RD
DAVIS, CA 95616
Yolo County (530) 771-4000
DR. BENTON JAMES RUNQUIST D.D.S., M.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
635 ANDERSON RD, SUITE #6
DAVIS, CA 95616
Yolo County (530) 756-0220
HANGER PROSTHETICS & ORTHOTICS WEST, INC.
Prosthetic/Orthotic Supplier
635 ANDERSON RD, SUITE 18
DAVIS, CA 95616
Yolo County (530) 204-5123
DR. TYLER POLAND D.C.
Chiropractor
635 ANDERSON RD, STE 14
DAVIS, CA 95616
Yolo County (530) 400-8390
JEFFRY METHENY M.D.
Specialist
635 ANDERSON RD, #18
DAVIS, CA 95616
Yolo County (530) 771-4000
DR. TRACY LEE BASSO DPM
Podiatrist
635 ANDERSON RD, STE 19
DAVIS, CA 95616
Yolo County (530) 758-1810

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 Michael Goodman's NPI number?

The NPI number for Michael Goodman is 1174558407. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Where is Michael Goodman located?

Michael Goodman practices at 635 Anderson Rd Suite 12B, Davis, CA 95616. The listed phone number is (530) 753-2787.

What is Michael Goodman's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Michael Goodman enrolled in Medicare?

No. Michael Goodman has opted out of Medicare through April 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Michael Goodman was last updated on July 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.