Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leslie L Goodavish, MMSPAC

Individual provider Physician Assistant · NPI 1730141987

Leslie L Goodavish, MMSPAC is a Physician Assistant in Madison, Wisconsin. Qualified in 2005, 21 years ago. Practices with University of Wisconsin Medical Foundation Inc, a 2,536-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Montana and Wisconsin.

Years since qualifying
21
Licensed in
MT, WI
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

4602 Eastpark Blvd
Madison, WI 53718-2002
Phone: (608) 263-8820
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 7929 Oak View Drive, Madison, WI 53719 — (608) 469-0232
  • 7929 Oak View Drive, Madison, WI 53719 — (608) 469-0232

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1933-23 (WI)
Physician Assistant Taxonomy 363A00000X · Licence MED-PAC-LIC-79429 (MT)

Record details

NPI number1730141987
Entity typeIndividual (Type 1)
GenderFemale
Credentials MMSPAC
Sole proprietorNo
NPI enumeratedApril 4, 2006
Last updated in NPPESFebruary 15, 2021
Certification dateFebruary 15, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice University Of Wisconsin Medical Foundation Inc — 2536 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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