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MR. CARL ROBERT GOODHOLM JR. LCSW
NPI 1609411024
Social Worker - Clinical in Jacksonville, FL

Active since November 08, 2019PECOS EnrolledAccepts Medicare Assignment
76.2/100
CMS Quality Rating
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: October 12, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 12, 2020, Nov 8, 2019 (2 updates tracked since 2019).

About Mr. Carl Robert Goodholm Jr. Lcsw NPPES

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

MR. CARL ROBERT GOODHOLM JR. LCSW (NPI 1609411024) is an individual clinical provider in Jacksonville, Florida, licensed in Florida (SW9760) and active in the NPI registry since November 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1609411024
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. CARL ROBERT GOODHOLM JR.Credential: LCSW
Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865
Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000
Phone(904) 953-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateNovember 8, 2019
Last NPPES UpdateOctober 12, 20202 updates tracked since enumeration
NPPES CertifiedOctober 12, 2020
✔ NPI 1609411024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in FL · SW9760
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4500 SAN PABLO RD S, Jacksonville, FL 32224
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

Mr. Carl Robert Goodholm Jr. Lcsw 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.

PECOS PAC ID5597190728
PECOS Enrollment IDI20200116002140
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 Carl Goodholm reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mayo Clinic Jacksonville
0.2 mi
Health Service
4500 SAN PABLO RD S
Jacksonville, FL 32224
  • Reassigned Medicare billing, Florida enrollment
  • 1,828 clinicians in this Medicare group
NPI 1174143986 (904) 953-2000

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 32224 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
$0.00 typical visit price
range $56.00 – $171.84
Typical copayment $0.00 (range $14.00 – $42.96)
Most-billed visit code NA
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.2/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.33
Promoting Interoperability100
Improvement Activities40
Cost51.32

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.

KATHERINE L WALSH PA-C/MPH
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
DR. JAMI ANN ROTHE KINNUCAN M.D.
Internal Medicine (Gastroenterology)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
GLENN SHI MD
Orthopaedic Surgery
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MICHELLE TULANG MD
Internal Medicine
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
RICARDO PAGAN MD
Hospitalist
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
CRYSTAL LYNN CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
LAUREN E FREED CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MRS. MELINA VOLNER SOMMESE PA-C
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2594

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 Carl Goodholm's NPI number?

The NPI number for Carl Goodholm is 1609411024. It was assigned to this individual provider in the NPPES registry on November 8, 2019.

Where is Carl Goodholm located?

Carl Goodholm practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.

What is Carl Goodholm's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Carl Goodholm enrolled in Medicare?

Yes. Carl Goodholm 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 organization bills Medicare for Carl Goodholm's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carl Goodholm reassigns Medicare benefits to Mayo Clinic Jacksonville (Jacksonville, 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 Carl Goodholm's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carl Goodholm accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Carl Goodholm 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 Carl Goodholm was last updated on October 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.