DR. MACKENZIE LEE GOODWIN (M.D) – Surgical Critical Care Physician, NPI 1942569231
Surgical Critical Care Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,601 GENERAL SURGERY in OH
Provider Addresses for DR. MACKENZIE LEE GOODWIN (M.D)
700 ACKERMAN RD STE 2120
COLUMBUS, OH 432021559
Phone: (614) 293-2101
Fax: (614) 293-9155
Type: Mailing
1581 DODD DR FL 1
COLUMBUS, OH 432101257
Phone: (614) 293-2101
Fax: (614) 293-9155
Type: Location
1893 E MILLBROOK RD
SALT LAKE CITY, UT 841063827
Phone: (228) 273-9021
Type: Mailing
MACKENZIE GOODWIN MD DBA WASATCH SURGICAL LLC
520 MEDICAL DR STE 300
BOUNTIFUL, UT 84010
Phone: (228) 273-9021
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $158.
Total Amount is formed as General ($158) + Research ($0) + Ownership ($0) = $158.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Medtronic, Inc. ($107).
Total Amount
$158
General + Research + Ownership
Payments
7
Total payment records
General Amount
$158
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $107 |
| Ethicon US, LLC | $24 |
| Hologic Sales and Service, LLC | $14 |
| Integra LifeSciences Corporation | $13 |
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: 2024-08-09
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 |
|---|---|---|---|---|
| I20201208001373 | I | General Surgery | UT | TBD |
| I20240809002149 | I | General Surgery | CO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43202)
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