WENDY MONIQUE GOODRICH (PA C) – Physician Assistant, NPI 1255400388
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,534 PHYSICIAN ASSISTANT in ID
Provider Addresses for WENDY MONIQUE GOODRICH (PA C)
623 S MAIN ST STE 1
MOSCOW, ID 838432983
Phone: (208) 882-2011
Fax: (208) 883-1853
Type: Location
101, West A Street, Moscow, Latah County, Idaho, 83843, United States
MOSCOW, ID 83843
Phone: (208) 882-0540
Type: Location
2021 K St NW
Suite 512
Washington, DC 200061003
Phone: (202) 293-3636
Fax: (202) 293-0289
Type: Location
2500 W A St Ste 101
Moscow, ID 83843
Phone: (208) 882-0540
Type: Location
South Main Street, Stephen Heights, Moscow, Lackawanna County, Pennsylvania, 18444, United States
MOSCOW, ID 838433042
Phone: (208) 882-2011
Type: Mailing
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: 2015-11-16
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 |
|---|---|---|---|---|
| I20151116002532 | I | Physician Assistant | ID | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83843)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | DC | 81002 | Urinalysis, manual test | 41 | 35 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IN | |
| Physician Assistant | WA | |
| - | ID | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| Family Practice | ID | |
| Family Practice | ID | |
| Family Practice | WA | |
| Physician Assistant | ID | |
| Physician Assistant | WA |
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