MARY BEVENS GOODMAN (NP-C) – Obstetrics & Gynecology Nurse Practitioner, NPI 1043677339
Obstetrics & Gynecology Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
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Provider Addresses for MARY BEVENS GOODMAN (NP-C)
450, North Roxbury Drive, Beverly Hills, Los Angeles County, California, 90210, United States
SUITE #500
BEVERLY HILLS, CA 902104231
Phone: (310) 277-2393
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-09-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170920000891 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96910 | Therapy procedure using ultraviolet radiation with tar or petroleum jelly application | 98 | 37 | $0 |
| 96920 | Treatment of inflammatory skin disease using laser, less than 250.0 sq cm | 40 | 18 | $0 |
Insurance plans in this area (ZIP 90210)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | HI | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA |
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