Individual provider Active NPI

Michael Goins, NP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1003920604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
332522 Issued in NY
Practice address
743 E 9TH St
New York, NY 10009-5335
Phone
(212) 677-7999
Fax
(212) 614-1844
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 332522 NY Primary

Addresses

Primary practice location

743 E 9TH St
New York, NY 10009-5335

Mailing address

57 Willoughby St
2ND FL
Brooklyn, NY 11201-5290
Phone (212) 645-8111

Other identifiers 1

IdentifierTypeStateIssuer
LICENSE NUMBEROtherNY332522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151110001033 NY Practitioner - Nurse Practitioner 6002823259 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Damian Family Care Centers, Inc. CurrentSince Jun 24, 2015 Accepting new patients
Housing Works Health Services III, Inc. CurrentSince Apr 1, 2016 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Jun 24, 2015 Accepting new patients

Locations

57 Willoughby St
Fl 2
Brooklyn, NY 11201
Phone (347) 473-7475

57 Willoughby St
Lowr
Brooklyn, NY 11201
Phone (718) 408-6522

57 Willoughby St
Brooklyn, NY 11201
Phone (718) 408-6522

13750 Jamaica Ave
Jamaica, NY 11435
Phone (718) 298-5100

8956 162nd St
#3
Jamaica, NY 11432
Phone (718) 297-8000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDAIAA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003920604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WILLOUGHBY ST",
            "address_2": "2ND FL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015290",
            "telephone_number": "212-645-8111",
            "fax_number": "212-645-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 E 9TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100095335",
            "telephone_number": "212-677-7999",
            "fax_number": "212-614-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOINS",
        "first_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "332522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "332522",
            "identifier": "LICENSE NUMBER",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.