Goodside Health Medical, Pllc - Medicare Primary Care in Fort Worth, TX

Goodside Health Medical, Pllc is a medicare enrolled primary clinic (Pediatrics) in Fort Worth, Texas. The current practice location for Goodside Health Medical, Pllc is 1701 River Run Ste 302, Fort Worth, Texas. For appointments, you can reach them via phone at (281) 203-5006. The mailing address for Goodside Health Medical, Pllc is 1701 River Run Ste 302, Fort Worth, Texas and phone number is (281) 203-5006.

Goodside Health Medical, Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1548999451. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (281) 203-5006.

Contact Information

Goodside Health Medical, Pllc
1701 River Run Ste 302
Fort Worth
TX 76107-6547
(281) 203-5006
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameGoodside Health Medical, Pllc
SpecialityPediatrics
Location1701 River Run Ste 302, Fort Worth, Texas
Authorized Official Name and PositionGerardo Reyes (OWNER)
Authorized Official Contact6304871556
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Goodside Health Medical, Pllc
1701 River Run Ste 302
Fort Worth
TX 76107-6547

Ph: (281) 203-5006
Goodside Health Medical, Pllc
1701 River Run Ste 302
Fort Worth
TX 76107-6547

Ph: (281) 203-5006

NPI Details:

NPI Number1548999451
Provider Enumeration Date06/07/2022
Last Update Date04/28/2023

Medicare PECOS Information:

Medicare PECOS PAC ID1557745478
Medicare Enrollment IDO20220826000394

Medical Identifiers

Medical identifiers for Goodside Health Medical, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548999451NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Primary
261Q00000XClinic/center (* (Not Available))Secondary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Secondary
363A00000XPhysician Assistant (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Goodside Health Medical, Pllc acts as a billing entity for following providers:
Provider NameBethany Mcclean
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639148190
PECOS PAC ID: 5991738411
Enrollment ID: I20050915000346
Provider NameJesse R Zaitchik
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194052779
PECOS PAC ID: 6406986959
Enrollment ID: I20100610000503
Provider NameSabrina Didarali
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508118282
PECOS PAC ID: 1052564598
Enrollment ID: I20130110000599
Provider NameDonna Ignacio Vasquez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1154333169
PECOS PAC ID: 5496759136
Enrollment ID: I20140617002051
Provider NameMonica Danielle Lennox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467822114
PECOS PAC ID: 2264733559
Enrollment ID: I20151210000146
Provider NameLaura R Driggers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952757825
PECOS PAC ID: 9537459128
Enrollment ID: I20160610000638
Provider NameBear B Causseaux
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770034548
PECOS PAC ID: 5799068052
Enrollment ID: I20170210001177
Provider NameGillian Elisabeth Palmer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528583556
PECOS PAC ID: 3274807516
Enrollment ID: I20170925002752
Provider NameSujan Gogu
Provider TypePractitioner - Sports Medicine
Provider IdentifiersNPI Number: 1407268162
PECOS PAC ID: 8729357116
Enrollment ID: I20180912001243
Provider NameMagaly Orozco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922576123
PECOS PAC ID: 5597001586
Enrollment ID: I20190111002368
Provider NameLeigh A Dixon
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1558342360
PECOS PAC ID: 5496705576
Enrollment ID: I20191112000990
Provider NameDomingo Palomo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275025983
PECOS PAC ID: 2062849235
Enrollment ID: I20200227002414
Provider NameGerardo Reyes
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1194767954
PECOS PAC ID: 1153429576
Enrollment ID: I20200422000965
Provider NameChrista R Rosenberg
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1619238912
PECOS PAC ID: 1759697626
Enrollment ID: I20211108001306
Provider NameJulia Lowe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992050314
PECOS PAC ID: 9638326218
Enrollment ID: I20211117000440
Provider NameNicole Ivett Blanco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427758382
PECOS PAC ID: 1355707563
Enrollment ID: I20230512002590
Provider NameLindsay Agolia
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1831351063
PECOS PAC ID: 6406081421
Enrollment ID: I20230529000090
Provider NameAlison Glee Reagan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568088581
PECOS PAC ID: 9335506468
Enrollment ID: I20230606001033
Provider NameTatianna Natalia Mai
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972183895
PECOS PAC ID: 3971961806
Enrollment ID: I20230623002831
Provider NameElizabeth Rosenberg
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1891215612
PECOS PAC ID: 2769886563
Enrollment ID: I20230817002343
Provider NameLauren Viergever
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598432544
PECOS PAC ID: 3678921939
Enrollment ID: I20231127002190

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.