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ANDREW GOODRUM PA-C
NPI 1245077577
Physician Assistant in San Leandro, CA

Active since July 12, 2024PECOS Enrolled
13690 E 14TH ST STE 200, SAN LEANDRO, CA 94578(510) 297-0550 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 3, 2025, May 15, 2025, May 6, 2025 and 2 more (5 updates tracked since 2024).

About Andrew Goodrum Pa-c NPPES

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

ANDREW GOODRUM PA-C (NPI 1245077577) is an individual physician assistant in San Leandro, California, licensed in California (PA66152) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Oakland, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1245077577
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameANDREW GOODRUMCredential: PA-C
Location Address13690 E 14TH ST STE 200San Leandro, CA 94578-2584
Mailing AddressPo Box 14376San Francisco, CA 94114-0376
Phone(510) 297-0550
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 12, 2024
Last NPPES UpdateJune 3, 20255 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
✔ NPI 1245077577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA66152
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
13690 E 14TH ST STE 200, San Leandro, CA 94578
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Secondary Practice Location 1

Location 13100 Telegraph AveOakland, CA 94609-3239 · Phone (800) 607-6377

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Goodrum Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698287548
PECOS Enrollment IDI20250625002705
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 94578 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
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 4

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

EAST BAY HAND MEDICAL CENTER, INC
Specialist
13690 E 14TH ST STE 200
SAN LEANDRO, CA 94578
Alameda County (510) 297-0550
DR. JESSE DASHE M.D.
Orthopaedic Surgery (Hand Surgery)
13690 E 14TH ST STE 200
SAN LEANDRO, CA 94578
Alameda County (510) 297-0550
ORRIN FRANKO MD
Orthopaedic Surgery (Hand Surgery)
13690 E 14TH ST STE 200
SAN LEANDRO, CA 94578
Alameda County (510) 297-0550
MARIKO ELIZABETH BLUMENFELD FNP
Nurse Practitioner (Family)
13690 E 14TH ST STE 200
SAN LEANDRO, CA 94578
Alameda County (510) 297-0550

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 Andrew Goodrum's NPI number?

The NPI number for Andrew Goodrum is 1245077577. It was assigned to this individual provider in the NPPES registry on July 12, 2024.

Where is Andrew Goodrum located?

Andrew Goodrum practices at 13690 E 14th St Ste 200, San Leandro, CA 94578. The listed phone number is (510) 297-0550.

What is Andrew Goodrum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Andrew Goodrum enrolled in Medicare?

Yes. Andrew Goodrum is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Andrew Goodrum was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.