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MARK A GOFORTH NURSE PRACTITIONER
NPI 1699198747
Nurse Practitioner - Psychiatric/Mental Health in Vail, AZ

Active since January 27, 2014PECOS Enrolled
14029 E CAMINO GALANTE, VAIL, AZ 85641(520) 904-7987 Get Directions Write a Review

NPPES record last updated: August 26, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mark A Goforth Nurse Practitioner NPPES

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

MARK A GOFORTH NURSE PRACTITIONER (NPI 1699198747) is an individual psychiatric/mental health provider in Vail, Arizona, licensed in Arizona (AP4993) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699198747
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMARK A GOFORTHCredential: NURSE PRACTITIONER
Location Address14029 E CAMINO GALANTEVail, AZ 85641-2067
Mailing Address14029 E. Camino GalanteVail, AZ 85641 · (520) 904-7987
Phone(520) 904-7987
Sole ProprietorNo
Enumeration DateJanuary 27, 2014
Last NPPES UpdateAugust 26, 2025
NPPES CertifiedAugust 26, 2025
✔ NPI 1699198747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in AZ · AP4993
14029 E CAMINO GALANTE, Vail, AZ 85641
Open in Google Maps ↗

Other Names 1

Professional Name (2)Mark A Goforth Np

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark A Goforth 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 Reassignments

2

Medicare enrollment records show Mark Goforth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Connections Southernaz, LLC
15 mi
Adult Mental Health
2802 E DISTRICT ST FL 2
Tucson, AZ 85714
  • Reassigned Medicare billing, Arizona enrollment
  • 37 clinicians in this Medicare group
NPI 1821755141 (520) 301-2400
East Valley Psychiatry LLC
105 mi
Psychiatry
1301 S CRISMON RD
Mesa, AZ 85209
  • Reassigned Medicare billing, Arizona enrollment
  • 19 clinicians in this Medicare group
NPI 1992240857 (623) 308-2472

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 85641 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

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 Mark Goforth's NPI number?

The NPI number for Mark Goforth is 1699198747. It was assigned to this individual provider in the NPPES registry on January 27, 2014. The provider is also known as Mark A Goforth Np.

Where is Mark Goforth located?

Mark Goforth practices at 14029 E Camino Galante, Vail, AZ 85641. The listed phone number is (520) 904-7987.

What is Mark Goforth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mark Goforth enrolled in Medicare?

Yes. Mark Goforth is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mark Goforth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Goforth reassigns Medicare benefits to 2 organizations: Connections Southernaz, LLC (Tucson, AZ) and East Valley Psychiatry LLC (Mesa, AZ). 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 Mark Goforth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Goforth accept?

Health plans from Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and UnitedHealthcare list Mark Goforth 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 Mark Goforth was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.