DR. GARY M GOODMAN (MD) – Pediatric Allergy/Immunology Physician, NPI 1811999485
Pediatric Allergy/Immunology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
115 ALLERGY/IMMUNOLOGY in MO
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Provider Addresses for DR. GARY M GOODMAN (MD)
456, North New Ballas Road, Creve Coeur, Saint Louis County, Missouri, 63141, United States
STE 129
SAINT LOUIS, MO 631416812
Phone: (314) 569-1881
Fax: (314) 569-3277
Type: Mailing
Saint Louis Childrens Hospital School, 1, Children's Place, Central West End, City of Saint Louis, Missouri, 63110, United States
SAINT LOUIS, MO 631101002
Phone: (314) 454-2694
Fax: (314) 454-2515
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 161 Open Payments records for all available years, with a total value of $3,048.
Total Amount is formed as General ($3,048) + Research ($0) + Ownership ($0) = $3,048.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($819).
Total Amount
$3,048
General + Research + Ownership
Payments
161
Total payment records
General Amount
$3,048
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
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: 2009-03-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20040525000022 | I | Allergy/Immunology | AZ | TBD |
| I20090311000461 | I | Allergy/Immunology | MO | 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 |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 2,725 | 47 | $0 |
| 95117 | Professional service for multiple injections of allergen | 1,704 | 112 | $0 |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 1,166 | 98 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 304 | 198 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 62 | 62 | $0 |
Insurance plans in this area (ZIP 63141)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ALLERGY/IMMUNOLOGY | MO | 95004 | Injection of allergenic extracts into skin, accessed through the skin | 2791 | 51 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| A L L E R G Y/ I M M U N O L O G Y | MO | |
| Nurse Practitioner | MO | |
| Pediatric Medicine, Allergy/Immunology | MO | |
| - | MO |
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