JERRY L GODDARD M.D.
NPI 1295711240
Family Medicine in Carbondale, IL
About Jerry L Goddard M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRY L GODDARD M.D. (NPI 1295711240) is an individual family medicine provider in Carbondale, Illinois, licensed in Illinois (036-054846) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in West Frankfort, and is a graduate of Tulane University School Of Medicine (1970).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jerry L Goddard M.d. 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.
Medicare Billing Reassignments
3Medicare enrollment records show Jerry Goddard reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Carbondale, IL 62901
- Reassigned Medicare billing, Illinois enrollment
- 27 clinicians in this Medicare group
Springfield, IL 62702
- Reassigned Medicare billing, Illinois enrollment
- 262 clinicians in this Medicare group
Springfield, IL 62702
- Reassigned Medicare billing, Illinois enrollment
- 645 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
CARBONDALE, IL 62901
CARBONDALE, IL 62901
CARBONDALE, IL 62901
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 Jerry Goddard's NPI number?
The NPI number for Jerry Goddard is 1295711240. It was assigned to this individual provider in the NPPES registry on December 21, 2005.
Where is Jerry Goddard located?
Jerry Goddard practices at 305 W Jackson St Ste 200, Carbondale, IL 62901. The listed phone number is (618) 536-6621.
What is Jerry Goddard's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Jerry Goddard enrolled in Medicare?
Yes. Jerry Goddard 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.
Which organizations bill Medicare for Jerry Goddard's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Goddard reassigns Medicare benefits to 3 organizations: Southern Illinois Hospital Services (Carbondale, IL), Board Of Trustees Of Southern Illinois University (Springfield, IL) and Siu Physicians & Surgeons, Inc (Springfield, IL). Each 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 Jerry Goddard's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jerry Goddard accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Jerry Goddard as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jerry Goddard was last updated on December 28, 2020. 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.
# Jerry L Goddard, M.D. · NPI 1295711240
Family Medicine physician in Carbondale, Illinois. Individual provider, active in the CMS NPPES registry since December 21, 2005.
## Identity
- **NPI:** 1295711240 (Entity type: Individual)
- **Enumerated:** December 21, 2005
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 036-054846 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 305 W JACKSON ST, STE 200, Carbondale, IL 62901-1474
- **Phone:** (618) 536-6621 · **Fax:** (618) 453-1102
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Southern Illinois Hospital Services (NPI 1093801797, Carbondale, IL); Board Of Trustees Of Southern Illinois University (NPI 1396097960, Springfield, IL); Siu Physicians & Surgeons, Inc (NPI 1558385989, Springfield, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Tulane University School Of Medicine, class of 1970
## Record status
- **NPPES last updated:** December 28, 2020
- **Other identifiers:** Medicaid 036054846 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1295711240) · Data from the CMS NPPES public registry.