MARK GOODRICH (PAC) – Physician Assistant, NPI 1356447882
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Loading map...
Provider Addresses for MARK GOODRICH (PAC)
1477, North 2000 West, Clinton, Davis County, Utah, 84015, United States
WESTSIDE MEDICAL
CLINTON, UT 84015
Phone: (801) 774-8888
Fax: (801) 825-8519
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 131 Open Payments records for all available years, with a total value of $2,379.
Total Amount is formed as General ($2,379) + Research ($0) + Ownership ($0) = $2,379.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($699).
Total Amount
$2,379
General + Research + Ownership
Payments
131
Total payment records
General Amount
$2,379
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
| Company | Amount |
|---|---|
| ABBVIE INC. | $699 |
| AstraZeneca Pharmaceuticals LP | $263 |
| Axsome Therapeutics, Inc. | $105 |
| Lilly USA, LLC | $102 |
| Novo Nordisk Inc | $99 |
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: 2005-06-09
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 |
|---|---|---|---|---|
| I20050609001067 | I | Physician Assistant | UT | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 124 | 82 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 47 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 42 | 34 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 40 | 34 | $0 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 37 | 11 | $0 |
Insurance plans in this area (ZIP 84015)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| - | UT | |
| Family Practice | UT | |
| Family Practice | UT |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.