MR. LEDONTRAE GOODEN PA-C
NPI 1528607272
Physician Assistant - Medical in Fort Moore, GA
About Mr. Ledontrae Gooden Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. LEDONTRAE GOODEN PA-C (NPI 1528607272) is an individual medical provider in Fort Moore, Georgia and active in the NPI registry since December 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses 2
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
Mr. Ledontrae Gooden Pa-c 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.
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.
FORT MOORE, GA 31905
FORT BENNING, GA 31905
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 Ledontrae Gooden's NPI number?
The NPI number for Ledontrae Gooden is 1528607272. It was assigned to this individual provider in the NPPES registry on December 28, 2019.
Where is Ledontrae Gooden located?
Ledontrae Gooden practices at 6600 Van Aalst Blvd, Fort Moore, GA 31905. The listed phone number is (916) 385-1006.
What is Ledontrae Gooden's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Ledontrae Gooden enrolled in Medicare?
Yes. Ledontrae Gooden 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.
When was this NPI record last updated?
The NPPES record for Ledontrae Gooden was last updated on January 22, 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.
# Mr. Ledontrae Gooden, PA-C · NPI 1528607272
Medical physician in Fort Moore, Georgia. Individual provider, active in the CMS NPPES registry since December 28, 2019.
## Identity
- **NPI:** 1528607272 (Entity type: Individual)
- **Enumerated:** December 28, 2019
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6600 VAN AALST BLVD, Fort Moore, GA 31905-2102
- **Phone:** (916) 385-1006
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** January 22, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1528607272) · Data from the CMS NPPES public registry.