Individual provider Active NPI

Lauren Goedtel, PAC

  • Medical Physician Assistant
  • Troy, MI
National Provider Identifier
1104255496
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006722 Issued in MI
Practice address
44199 Dequindre Rd Ste G-10
Troy, MI 48085-1166
Phone
(248) 964-6111
NPI assigned
Nov 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006722 MI
Medical Physician Assistant 363AM0700X 5601006722 MI Primary

Addresses

Primary practice location

44199 Dequindre Rd Ste G-10
Troy, MI 48085-1166

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

3577 W 13 Mile Rd
Ste 103
Royal Oak, MI 48073-6710
Phone (248) 288-4500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgoedtel1235328@epic00.shdirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20181109000373 MI Practitioner - Physician Assistant 1153675129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals, P.C. CurrentSince Sep 30, 2018 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Sep 30, 2018 Accepting new patients
Michigan Healthcare Professionals PC Past Accepting new patients

Locations

6770 Dixie Hwy
Ste 107
Clarkston, MI 48346
Phone (248) 625-7506

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3577 W 13 Mile Rd
Ste 103
Royal Oak, MI 48073
Phone (248) 288-4500

4550 Investment Dr
Ste B120
Troy, MI 48098
Phone (248) 267-6569

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.

Hospital & facility affiliations 3

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": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1104255496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD STE G-10",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851166",
            "telephone_number": "248-964-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3577 W 13 Mile Rd",
            "address_2": "Ste 103",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736710",
            "country_code": "US",
            "telephone_number": "248-288-4500",
            "fax_number": "248-288-1378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOEDTEL",
        "first_name": "LAUREN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006722",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgoedtel1235328@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "44199 Dequindre Rd Ste G-10",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.