MARY LISA GOODMAN NURSE PRACTITIONER
NPI 1265105803
Nurse Practitioner - Adult Health in New Port Richey, FL

Q: What is Mary Goodman's NPI number?

The NPI number for Mary Goodman is 1265105803. It was assigned to this individual provider in the NPPES registry on July 29, 2021.

Q: What is Mary Goodman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Mary Goodman was last updated on July 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 July 29, 2021PECOS Enrolled

1807 SHORT BRANCH DR STE 102, NEW PORT RICHEY, FL 34655(727) 376-3547 Get Directions Write a Review

NPPES record last updated: July 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mary Lisa Goodman Nurse Practitioner NPPES

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

MARY LISA GOODMAN NURSE PRACTITIONER (NPI 1265105803) is an individual adult health provider in New Port Richey, Florida, licensed in Florida (11014405) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265105803

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMARY LISA GOODMANCredential: NURSE PRACTITIONER

Location Address1807 SHORT BRANCH DR STE 102New Port Richey, FL 34655-4424

Mailing Address4404 W Ballast Point BlvdTampa, FL 33611-5602 · (813) 895-4727

Phone(727) 376-3547

Sole ProprietorNo

Enumeration DateJuly 29, 2021

NPPES CertifiedJuly 29, 2021

✔ NPI 1265105803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in FL · 11014405

1807 SHORT BRANCH DR STE 102, New Port Richey, FL 34655

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Lisa Goodman Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Goodman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Trinity Family And Sports Medicine PA

Same address

Sports Medicine

1807 SHORT BRANCH DR, #102
Trinity, FL 34655

Reassigned Medicare billing, Florida enrollment
3 clinicians in this Medicare group

NPI 1891991238 (727) 376-3547

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

135 services86 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

44 services44 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

40 services40 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

34 services29 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34655 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 2

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

JULIANE CHAVEZ

Nurse Practitioner (Adult Health)

1807 SHORT BRANCH DR STE 102
TRINITY, FL 34655

Pasco County (727) 376-3547

LEEANN WISNOWSKI ARNP

Nurse Practitioner (Family)

1807 SHORT BRANCH DR STE 102
TRINITY, FL 34655

Pasco County (727) 376-3547

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 Mary Goodman's NPI number?

The NPI number for Mary Goodman is 1265105803. It was assigned to this individual provider in the NPPES registry on July 29, 2021.

Where is Mary Goodman located?

Mary Goodman practices at 1807 Short Branch Dr Ste 102, New Port Richey, FL 34655. The listed phone number is (727) 376-3547.

What is Mary Goodman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Mary Goodman enrolled in Medicare?

Yes. Mary Goodman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Goodman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Goodman reassigns Medicare benefits to Trinity Family And Sports Medicine PA (Trinity, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Goodman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Goodman was last updated on July 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.