JESSE GOODALL MD
NPI 1669958286
Student in an Organized Health Care Education/Training Program in Baltimore, MD
About Jesse Goodall Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSE GOODALL MD (NPI 1669958286) is an individual student in an organized health care education/training program in Baltimore, Maryland and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jesse Goodall Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
BALTIMORE, MD 21215
BALTIMORE, MD 21215
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 Jesse Goodall's NPI number?
The NPI number for Jesse Goodall is 1669958286. It was assigned to this individual provider in the NPPES registry on July 17, 2018.
Where is Jesse Goodall located?
Jesse Goodall practices at 2401 W Belvedere Ave, Baltimore, MD 21215. The listed phone number is (410) 601-7639.
What is Jesse Goodall's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jesse Goodall enrolled in Medicare?
Yes. Jesse Goodall is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jesse Goodall was last updated on July 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Jesse Goodall, MD · NPI 1669958286
Student in an Organized Health Care Education/Training Program provider in Baltimore, Maryland. Individual provider, active in the CMS NPPES registry since July 17, 2018.
## Identity
- **NPI:** 1669958286 (Entity type: Individual)
- **Enumerated:** July 17, 2018
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2401 W BELVEDERE AVE, Baltimore, MD 21215-5216
- **Phone:** (410) 601-7639
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 17, 2018
---
Source: [NPI Profile](https://npiprofile.com/npi/1669958286) · Data from the CMS NPPES public registry.