MATTHEW MORTENSEN GOODMAN (M.D) – Dermatology Physician, NPI 1679556633

MATTHEW MORTENSEN GOODMAN (M.D) is a healthcare provider. based in Santa ana, California. specializing in DERMATOLOGY. They hold the professional credentials M.D. They hold a License No. G53769 (CA). The NPI Number for MATTHEW MORTENSEN GOODMAN (M.D) is 1679556633

Main info

Male
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW MORTENSEN GOODMAN (M.D)
NPI
1679556633
Phone
(714) 547-5151
Address
1125 E 17TH STREET
Enumeration Date
23 November 2005
Last Update Date
13 November 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Secondary Phone
6232547375
Graduation Year
1983 (43 years ago)
PAC ID
4587721956
Group Practice PAC ID
6406203686
Professional Enrollment ID
I20231109001142
Address ID
AZ853754746SU13830SOLX507
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,140 DERMATOLOGY in CA

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Provider Addresses for MATTHEW MORTENSEN GOODMAN (M.D)

  • 1125, East 17th Street, Santa Ana, Orange County, California, 92701, United States

    STE W-248

    SANTA ANA, CA 92701

    Phone: (714) 547-5151

    Fax: (714) 547-4027

    Type: Mailing

  • 9151 W Thunderbird Rd Ste G104

    Peoria, AZ 853814906

    Phone: (623) 254-7375

    Fax: (623) 259-6754

    Type: Location

  • 13261 CROMWELL DR

    TUSTIN, CA 927804705

    Phone: (714) 955-1214

    Fax: (623) 259-6754

    Type: Mailing

  • 180 NEWPORT CENTER DR STE 158

    NEWPORT BEACH, CA 926600934

    Phone: (949) 719-1800

    Fax: (949) 719-1810

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $103.

Total Amount is formed as General ($103) + Research ($0) + Ownership ($0) = $103.

Last reported payment date: 2024-11-21 • Largest payer in this snapshot: ABBVIE INC. ($53).

Total Amount

$103

General + Research + Ownership

Payments

5

Total payment records

General Amount

$103

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-11-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090330000523IDermatologyCATBD
I20231109001142IDermatologyAZTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths26234$0
99213Established patient office or other outpatient visit, 20-29 minutes11370$0
17000Destruction of precancer skin growth, 1 growth9751$0
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks9265$0
99214Established patient office or other outpatient visit, 30-39 minutes5833$0
View full utilization report →

Insurance plans in this area (ZIP 92701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406203686View full group profile
NameSpecialtyState
D E R M A T O L O G YAZ

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Frequently asked questions

What is the 10-digit NPI for MATTHEW MORTENSEN GOODMAN (M.D)?
MATTHEW MORTENSEN GOODMAN (M.D) — NPI 1679556633 — is the standard way to identify this listing.
Can I rely on MATTHEW MORTENSEN GOODMAN (M.D) being an active provider?
As of the registry snapshot, MATTHEW MORTENSEN GOODMAN (M.D) is marked active.
What taxonomy line describes MATTHEW MORTENSEN GOODMAN (M.D)?
For research purposes, treat MATTHEW MORTENSEN GOODMAN (M.D) as Dermatology Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for MATTHEW MORTENSEN GOODMAN (M.D)?
MATTHEW MORTENSEN GOODMAN (M.D)'s geographic hint is Santa Ana, California in our summary view.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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