Randall J Goodfriend, is a medicare enrolled "Counselor - Professional" provider in Superior, Arizona. His current practice location is
400 S Main, Superior, Arizona. You can reach out to his office (for appointments etc.) via phone at
(480) 288-5328.
Randall J Goodfriend is licensed to practice in Arizona (license number LPC-2392) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1467646760.
Healthcare Provider's Profile
Full Name | Randall J Goodfriend |
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Gender | Male |
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Speciality | Counselor - Professional |
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Location | 400 S Main, Superior, Arizona |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1467646760
- Provider Enumeration Date: 08/29/2007
- Last Update Date: 08/29/2007
Medicare PECOS Information:
- PECOS PAC ID: 5496105488
- Enrollment ID: I20240103003093
Medical Identifiers
Medical identifiers for Randall J Goodfriend such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467646760 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | LPC-2392 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Randall J Goodfriend allows following entities to bill medicare on his behalf.
Entity Name | Black Canyon Community Health Center Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1679723217 PECOS PAC ID: 6406900331 Enrollment ID: O20090812000350 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Randall J Goodfriend is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Randall J Goodfriend, Po Box 3160, Apache Junction, AZ 85217-3160 Ph: (480) 288-5328 | Randall J Goodfriend, 400 S Main, Superior, AZ 85273-0004 Ph: (480) 288-5328 |
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