GLENN GOODWIN (DO) – Emergency Medicine Physician, NPI 1275161036

GLENN GOODWIN (DO) is a healthcare provider. based in Aventura, Florida. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. TP220 (KY). The NPI Number for GLENN GOODWIN (DO) is 1275161036

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
GLENN GOODWIN (DO)
NPI
1275161036
Phone
(305) 682-2483
Address
20900 BISCAYNE BLVD
Enumeration Date
29 March 2020
Last Update Date
10 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3088657100
Graduation Year
2020 (6 years ago)
PAC ID
7214377704
Group Practice PAC ID
1153677828
Professional Enrollment ID
I20240517001676
Address ID
NE688472908KE10XXXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:6State licenses:2Digital endpointsOther names

3,232 EMERGENCY MEDICINE in FL

Provider Addresses for GLENN GOODWIN (DO)

  • 20900 BISCAYNE BLVD

    AVENTURA, FL 331801407

    Phone: (305) 682-2483

    Fax: (305) 682-5250

    Type: Mailing

  • 200 E Chestnut St

    Louisville, KY 402021831

    Phone: (502) 629-8000

    Fax: (502) 629-6129

    Type: Location

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: 2024-11-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
I20240517001676IEmergency MedicineNETBD
I20240621001517IEmergency MedicineKYTBD
I20241101003325IEmergency MedicineHITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33180)

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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: 1153677828View full group profile
NameSpecialtyState
Emergency MedicineOK
Physician AssistantNE
Nurse PractitionerNE
Physician AssistantNE
Emergency MedicineMO
Emergency MedicineMD

Reviews

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Frequently asked questions

Is there an official ID for GLENN GOODWIN (DO) in U.S. healthcare records?
The official identifier for GLENN GOODWIN (DO) is NPI 1275161036.
Would GLENN GOODWIN (DO) appear as active to a payer?
You can treat GLENN GOODWIN (DO) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for GLENN GOODWIN (DO)?
At a glance, GLENN GOODWIN (DO) is tied to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Florida is GLENN GOODWIN (DO) registered?
Use Aventura, Florida as the headline location for GLENN GOODWIN (DO) here.
Can I trust this NPI listing for GLENN GOODWIN (DO)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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