NPIMap

Individual provider Active NPI

Katelyn Goff, PA

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1013506625
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010273 Issued in MI
Practice address
4024 Park East CT SE
Grand Rapids, MI 49546-8810
Phone
(231) 592-1360
Fax
(231) 592-1361
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601010273 MI Primary

Addresses

Primary practice location

4024 Park East CT SE
Grand Rapids, MI 49546-8810

Mailing address

20095 Gilbert Rd
Big Rapids, MI 49307-2365
Phone (231) 592-1360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126002676 MI Practitioner - Physician Assistant 5496169807 Reassigns benefits to 14 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Primary Care Partners P CGroup PAC ID 8527044551, 21 clinicians

Practice addresses (Care Compare)

20095 Gilbert Rd
Suite B
Big Rapids, MI 49307-2366
Phone (231) 592-1360

4024 Park E CT SE
Grand Rapids, MI 49546-8810
Phone (231) 592-1360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.01
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services of Michigan, P.C. CurrentSince Jun 6, 2022 Accepting new patients
Taylor Urgent Care PC CurrentSince Jan 18, 2021 Accepting new patients
Michigan Institute of Urology PC CurrentSince Jun 6, 2022 Accepting new patients
Farmington Hills Urgent Care Walk-in Clinic PC PastSince Jul 31, 2022 Accepting new patients

Locations

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

23234 Ecorse Rd
Taylor, MI 48180
Phone (313) 292-8400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BADACD/Endpoint/BADACD
  • Direct secure messaging: kgoff841974@direct.hfhs.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1013506625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20095 GILBERT RD",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072365",
            "telephone_number": "231-592-1360",
            "fax_number": "231-592-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 PARK EAST CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468810",
            "telephone_number": "231-592-1360",
            "fax_number": "231-592-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "KATELYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.