DR. GARY M GOODMAN (MD) – Pediatric Allergy/Immunology Physician, NPI 1811999485

DR. GARY M GOODMAN (MD) is a healthcare provider. based in Saint louis, Missouri. specializing in ALLERGY/IMMUNOLOGY, PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. 102527 (MO). The NPI Number for DR. GARY M GOODMAN (MD) is 1811999485

Main info

Male
45 Years Of Experience
Name
DR. GARY M GOODMAN (MD)
NPI
1811999485
Phone
(314) 569-1881
Address
456 N NEW BALLAS RD
Enumeration Date
12 August 2005
Last Update Date
19 February 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
3145691881
Graduation Year
1981 (45 years ago)
PAC ID
8527049832
Group Practice PAC ID
9335110949
Professional Enrollment ID
I20090311000461
Address ID
MO631416812SA456XXRDXX512
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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

View all Open Payments →|Open Payments Risk Radar →

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040525000022IAllergy/ImmunologyAZTBD
I20090311000461IAllergy/ImmunologyMOTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
95004Test for allergy using allergenic extract2,72547$0
95117Professional service for multiple injections of allergen1,704112$0
95165Professional service for preparation and provision of 1 or more antigens1,16698$0
99214Established patient office or other outpatient visit, 30-39 minutes304198$0
99204New patient office or other outpatient visit, 45-59 minutes6262$0
View full utilization report →

Insurance plans in this area (ZIP 63141)

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Provider's Procedures

DR. GARY M GOODMAN (MD) performs procedures in ALLERGY/IMMUNOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ALLERGY/IMMUNOLOGYMO95004Injection of allergenic extracts into skin, accessed through the skin279151

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335110949View full group profile
NameSpecialtyState
A L L E R G Y/ I M M U N O L O G YMO
Nurse PractitionerMO
Pediatric Medicine, Allergy/ImmunologyMO
-MO

Reviews

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Frequently asked questions

Can I verify DR. GARY M GOODMAN (MD) with an NPI only?
You can start verification with NPI 1811999485 for DR. GARY M GOODMAN (MD), then check state licensing separately.
Is DR. GARY M GOODMAN (MD) still practicing?
DR. GARY M GOODMAN (MD) is currently listed as active in the public NPI registry.
What is DR. GARY M GOODMAN (MD) best known for clinically?
Directory data describes DR. GARY M GOODMAN (MD) with Pediatric Allergy/Immunology Physician. Clinical services aligned with this taxonomy classification.
Where is DR. GARY M GOODMAN (MD) based?
DR. GARY M GOODMAN (MD) is tied to Saint Louis, Missouri in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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