DIANA GOODWINE (MD) – Emergency Medicine Physician, NPI 1780840397
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,845 EMERGENCY MEDICINE in IL
Provider Addresses for DIANA GOODWINE (MD)
1100 E NORRIS DR
OTTAWA, IL 613501604
Phone: (815) 433-3100
Fax: (815) 433-0879
Type: Location
San Mateo Medical Center, 222, West 39th Avenue, Laurel, San Mateo, San Mateo County, California, 94403, United States
EMERGENCY DEPARTMENT
SAN MATEO, CA 944034364
Phone: (650) 573-2222
Type: Location
222 W 39th Ave
Emergency Department
San Mateo, CA 944034364
Phone: (650) 573-2222
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $2,188.
Total Amount is formed as General ($2,188) + Research ($0) + Ownership ($0) = $2,188.
Last reported payment date: 2024-11-30 • Largest payer in this snapshot: Philips North America LLC ($2,188).
Total Amount
$2,188
General + Research + Ownership
Payments
3
Total payment records
General Amount
$2,188
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Philips North America LLC | $2,188 |
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: 2024-10-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101029001343 | I | Emergency Medicine | IL | TBD |
| I20140616000567 | I | Emergency Medicine | CA | TBD |
| I20241007000096 | I | Emergency Medicine | IN | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 125 | 122 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 99 | 97 | $0 |
| 99291 | Critical care, first 30-74 minutes | 36 | 35 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 18 | 17 | $0 |
Insurance plans in this area (ZIP 61350)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | TN | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MO | |
| - | IL |
Reviews
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