TIFFANY MARIE GOODMAN (AGPCNP-BC) – Primary Care Nurse Practitioner, NPI 1265169676
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,192 NURSE PRACTITIONER in IN
Provider Addresses for TIFFANY MARIE GOODMAN (AGPCNP-BC)
10730 HUNTER LAKE LN
INDIANAPOLIS, IN 462398986
Phone: (317) 531-1783
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $611.
Total Amount is formed as General ($611) + Research ($0) + Ownership ($0) = $611.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($243).
Total Amount
$611
General + Research + Ownership
Payments
8
Total payment records
General Amount
$611
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
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: 2022-10-20
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 |
|---|---|---|---|---|
| I20221020001423 | I | Nurse Practitioner | 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 |
|---|---|---|---|---|
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 647 | 125 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 437 | 84 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 195 | 69 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 95 | 57 | $0 |
| 99350 | Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes | 55 | 36 | $0 |
Insurance plans in this area (ZIP 46239)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Physician Assistant | IN | |
| Family Practice | IN | |
| General Surgery | WA | |
| Family Practice | IN |
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