ERIC M. GODDARD (PA-C) – Physician Assistant, NPI 1053824763
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
2,510 PHYSICIAN ASSISTANT in IN
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Provider Addresses for ERIC M. GODDARD (PA-C)
6920 POINTE INVERNESS WAY STE 200
FORT WAYNE, IN 468047934
Phone: (260) 479-3514
Fax: (260) 479-3520
Type: Mailing
10343 DAWSONS CREEK BLVD STE A
FORT WAYNE, IN 468251906
Phone: (260) 203-9600
Fax: (260) 407-8006
Type: Mailing
Lutheran Hospital, 7950, West Jefferson Boulevard, Fort Wayne, Allen County, Indiana, 46804, United States
FORT WAYNE, IN 468044140
Phone: (260) 203-9600
Type: Location
7916 W JEFFERSON BLVD
FORT WAYNE, IN 468044140
Phone: (260) 434-6322
Fax: (260) 434-6481
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 110 Open Payments records for all available years, with a total value of $2,062.
Total Amount is formed as General ($2,062) + Research ($0) + Ownership ($0) = $2,062.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($601).
Total Amount
$2,062
General + Research + Ownership
Payments
110
Total payment records
General Amount
$2,062
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2017-11-27
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20171127000080 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 310 | 241 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 151 | 129 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 18 | 18 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 16 | 16 | $0 |
| 94618 | Test for exercise-induced lung stress | 12 | 12 | $0 |
Insurance plans in this area (ZIP 46804)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | IN | |
| Internal Medicine, Hospitalist, Internal Medicine | SD | |
| Physician Assistant | IN | |
| Nurse Practitioner | IN | |
| Internal Medicine, Hospitalist | IL | |
| Internal Medicine | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN |
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