DR. ANDREW DAVID GOODWILLIE (NPI# 1710144191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710144191 |
| Entity Type | Individual |
| Full Name | DR. ANDREW DAVID GOODWILLIE |
| Credential | M.D. |
| Practice Address |
611 Northern Blvd Suite 200 Great Neck NY 11021-5207 |
| Practice Telephone | 5167232663 |
| Practice Fax Number | 5163257190 |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2012-08-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
260885 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
611 NORTHERN BLVD SUITE 200 |
| City | GREAT NECK |
| State | NY |
| Zip Code | 11021-5207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598739989 | Thomas Michael Mauri | Orthopaedic Surgery | 611 Northern Blvd, Suite 200, Great Neck, NY 11021-5207 | 2006-02-14 |
| 1881293231 | Sini Varghese | Nurse Practitioner | 611 Northern Blvd, Great Neck, NY 11021-5207 | 2020-10-17 |
| 1629550769 | Alexandra Marie Mezzanotte | Physician Assistant | 611 Northern Blvd, Great Neck, NY 11021-5207 | 2018-09-05 |
| 1740637362 | Yael Cukier | Clinical Neuropsychologist | 611 Northern Blvd, Suite 150, Great Neck, NY 11021-5207 | 2016-05-24 |
| 1811356082 | Sheila Manzoor | Physician Assistant | 611 Northern Blvd, Suite 200, Great Neck, NY 11021-5207 | 2016-02-16 |
| 1083070320 | Richard T Miller Dmd PC | Dentist | 611 Northern Blvd, Great Neck, NY 11021-5207 | 2015-12-31 |
| 1386085082 | Tara Marie Vanderburg | Physician Assistant | 611 Northern Blvd, Suite 200, Great Neck, NY 11021-5207 | 2013-07-10 |
| 1013270230 | Sohrab Virk | General Practice | 611 Northern Blvd, Great Neck, NY 11021-5207 | 2012-06-21 |
| 1891082632 | Luca Giliberto | Psychiatry & Neurology | 611 Northern Blvd, Ste 150, North Shore-lij-cushing Neuroscience Institute, Great Neck, NY 11021-5207 | 2011-06-30 |
| 1972896629 | Lorrelei Ann Paires | Dentist | 611 Northern Blvd, Suite 100, Great Neck, NY 11021-5207 | 2011-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097927 | Vital Balance Osteopathy, Pllc | Psychiatry & Neurology | 10 Bond Street, Ste 1, #290, Great Neck, NY 11021 | 2020-09-14 |
| 1770131922 | Bond Orthodontics & Dental Care Pllc | Dentist | 12 Bond Street., Suite#c4, Great Neck, NY 11021 | 2019-08-30 |
| 1295393858 | Ctrip.nyc, Inc. | Emergency Response System Companies | 3 Grace Ave, Suite 106, Great Neck, NY 11021 | 2019-05-30 |
| 1366929267 | Vishva Vajra Acupuncture PC | Acupuncturist | 23a Middle Neck Road, Great Neck, NY 11021 | 2018-07-24 |
| 1518457530 | Assured Quality Home Care, Inc. | In Home Supportive Care | 885 Northern Blvd., Greak Neck, NY 11021 | 2018-05-15 |
| 1881183275 | Liat Mindy Brody | Occupational Therapist | 7 Hickory Dr, Great Neck, NY 11021 | 2018-05-01 |
| 1457853707 | Allison Squillace | Social Worker | 7 Bond Suite 1a, Great Neck, NY 11021 | 2018-03-02 |
| 1275042855 | Seolhee Kang | Acupuncturist | 26 Linden Street, Apt 4c, Great Neck, NY 11021 | 2017-09-26 |
| 1346781598 | Sara Dreiblatt | Speech-Language Pathologist | 211-45 46th Road, Queens, NY 11021 | 2017-03-20 |
| 1962853416 | Darron Yelling Do, PC | Surgery | 305 Northen Blvd, 105, Great Neck, NY 11021 | 2016-06-27 |
| Find all providers in zip 11021 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568644748 | David M. Dines, M.d.,p.c. | Orthopaedic Surgery | 935 Northern Blvd, Suite 303, Great Neck, NY 11021-5316 | 2007-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057347 | Viorika Chebotaru | Orthopaedic Surgery | 626 Sheepshead Bay Rd, Brooklyn, NY 11224-3602 | 2019-11-11 |
| 1609421122 | Mulchandani Medical Pllc | Orthopaedic Surgery | 139 Centre St Lbby Suite102, New York, NY 10013-4552 | 2019-08-02 |
| 1891258349 | Empire Ny Orthopedics PC | Orthopaedic Surgery | 22215 Northern Blvd Ste Lobbya, Bayside, NY 11361-3678 | 2019-04-11 |
| 1821566688 | Chelsea Rose Weir | Orthopaedic Surgery | 379 Oakwood Rd Ste C, Huntington Station, NY 11746-7203 | 2018-11-08 |
| 1578046421 | Djf Orthopedics and Sports Medicine | Orthopaedic Surgery | 165 W End Ave Apt 28p, New York, NY 10023-5516 | 2018-09-06 |
| 1992201222 | Scott Adam Weiss Md PC | Orthopaedic Surgery | 672 Harless Pl, West Hempstead, NY 11552-3504 | 2018-04-04 |
| 1467965095 | Melissa Pei-lih Mau | Orthopaedic Surgery | 2800 Marcus Ave Ste 102, New Hyde Park, NY 11042-1113 | 2017-11-06 |
| 1821476698 | Stephanie M Macdonald | Orthopaedic Surgery | 1672 Empire Blvd Ste 100, Webster, NY 14580-2199 | 2015-05-13 |
| 1710380118 | Stony Brook University | Orthopaedic Surgery | Toll Dr Bldg 39, Stony Brook, NY 11794-0001 | 2014-09-30 |
| 1083029623 | Michael J. Katz Md PC | Orthopaedic Surgery | 14653 Delaware Ave, Flushing, NY 11355-2182 | 2014-06-23 |
| Find all providers with the same taxonomy | ||||
| City | GREAT NECK |
| Zip Code | 11021 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.