MARK CHRISTOPHER GOETZ PHD
NPI 1780978023
Psychologist in Champlin, MN

Active since June 03, 2011PECOS Enrolled
83.53/100
CMS Quality Rating
11269 JEFFERSON HWY N, CHAMPLIN, MN 55316(763) 236-0600 Get Directions Write a Review

NPPES record last updated: April 9, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 9, 2021, May 18, 2017 (2 updates tracked since 2017).

About Mark Christopher Goetz Phd NPPES

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

MARK CHRISTOPHER GOETZ PHD (NPI 1780978023) is an individual psychologist in Champlin, Minnesota and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780978023
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameMARK CHRISTOPHER GOETZCredential: PHD
Location Address11269 JEFFERSON HWY NChamplin, MN 55316-3123
Mailing Address401 14th Ave SePuyallup, WA 98372 · (253) 697-2700
Sole ProprietorNo
Enumeration DateJune 3, 2011
Last NPPES UpdateApril 9, 20212 updates tracked since enumeration
NPPES CertifiedApril 9, 2021
NPI 1780978023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PY60230406 (WA)
Also ListedPsychologist · CounselingTaxonomy 103TC1900X
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License PY60230406 (WA)
Also ListedPsychologist · FamilyTaxonomy 103TF0000X
Also ListedPsychologist · HealthTaxonomy 103TH0004X
Also ListedPsychologist · RehabilitationTaxonomy 103TR0400X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License PY60230406 (WA)
11269 JEFFERSON HWY N, Champlin, MN 55316

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mark Christopher Goetz Phd 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 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.

83.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.79
Promoting Interoperability100
Improvement Activities40
Cost63.31

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.

Obstetrics & Gynecology
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Physical Therapist
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Dentist (General Practice)
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Dentist (General Practice)
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Dentist (General Practice)
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Pediatrics
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Nurse Practitioner (Family)
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316
Family Medicine
11269 JEFFERSON HWY N
CHAMPLIN, MN 55316

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 Goetz's NPI number?

The NPI number for Mark Goetz is 1780978023. It was assigned to this individual provider in the NPPES registry on June 3, 2011.

Where is Mark Goetz located?

Mark Goetz practices at 11269 Jefferson Hwy N, Champlin, MN 55316. The listed phone number is (763) 236-0600.

What is Mark Goetz's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Mark Goetz enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mark Goetz was last updated on April 9, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.