Tera Melanne Goldmakher, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301078436 Issued in MI

Practice address

33155 Annapolis St
Emergency Dept
Wayne, MI 48184-2405

Phone

(734) 467-4042

Fax

(734) 467-5500

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ies Oklahoma LLC

  • Emergency Medicine Physician
  • Lawton, OK
  • NPI 1437916525
  Medicare reassignment NPD
• Nes Oklahoma, Inc.

  • Emergency Medicine Physician
  • Ponca City, OK
  • NPI 1528040722
  Medicare reassignment NPD
• Bullhead City Clinic Corp

  dba Laughlin Walk In Care

  • Family Medicine Physician
  • Laughlin, NV
  • NPI 1700240884
  NPD (past)
• Bullhead City Clinic Corp

  • Surgery Physician
  • Bullhead City, AZ
  • NPI 1962429878

  Family Medicine

  NPD (past)
• Southwestern Medical Center, LLC

  dba Southwestern Medical Center

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1952359986
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1043258759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "address_2": "CREDENTIALING",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-805-0488",
            "fax_number": "866-250-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "address_2": "EMERGENCY DEPT",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-467-4042",
            "fax_number": "734-467-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAKHER",
        "first_name": "TERA",
        "middle_name": "MELANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "35769",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C53679",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301078436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11352458",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116476",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043258759",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Thara Glidden, LLBSWMI
• Gregory L. Gliha, PA
• Verneal Yvonne Glispie, CNP, MSN
• Linda Goachee, CMT
• Michana Golden
• Gregory Golicz, D.O.
• Erin Gonzalez
• Joi Gooden
• Joanna Marie Goodman
• Goodness Legacy Group Inc

• Emergency Medicine Physician in Wayne, MI
• Providers in Wayne, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.