Andrea Jo Goethals, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5101015223 Issued in MI

Practice address

8235 Holly Rd
Suite 1
Grand Blanc, MI 48439-2441

Phone

(810) 694-9700

Fax

(810) 694-9940

NPI assigned

Mar 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Michigan State University College of Osteopathic Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesys Practice Partners IncGroup PAC ID 3476456492, 37 clinicians

Henry Ford Health Genesys HospitalGroup PAC ID 2062323033, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andreagoethals@pmi.allscriptsdirect.net
• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
• Direct secure messaging: agoethals1130222@direct.hfhs.org

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.

• Genesys Practice Partners Inc

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1982647004
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Genesys Hospital

  • Podiatrist
  • Flint, MI
  • NPI 1528283033
  Medicare reassignment Care Compare group NPD
• Ascension Genesys Hospital

  • Skilled Nursing Facility
  • Grand Blanc, MI
  • NPI 1093125312
  NPD
• Genesys Practice Partners Inc

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1194774752
  NPD
• Genesys Practice Partners, Inc

  • Psychiatry Physician
  • Grand Blanc, MI
  • NPI 1336842160
  NPD
• Henry Ford Health Genesys Hospital

  • Clinical Psychologist
  • Burton, MI
  • NPI 1932368537
  NPD
• Surgical Associates, PLC

  • Surgery Physician
  • Grand Blanc, MI
  • NPI 1427197490
  NPD

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

• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1104956895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 HOLLY RD",
            "address_2": "SUITE 1",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392441",
            "telephone_number": "810-694-9700",
            "fax_number": "810-694-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8235 HOLLY RD",
            "address_2": "SUITE 1",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392441",
            "telephone_number": "810-694-9700",
            "fax_number": "810-694-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETHALS",
        "first_name": "ANDREA",
        "middle_name": "JO",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101015223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114995665",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN",
            "identifier": "46149",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "6U10108",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "01007313",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0252511984",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0252511984",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MEDICARE ADVAN",
            "identifier": "0N89830006",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENESEE HEALTH PLAN",
            "identifier": "01007313",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "382626202",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie A Giza
• Chris Gjerovski
• Glenn a Partridge DC PLC
• Global Physical Therapy and Spine Specialists
• Marianne Goergen, PSY.D.
• Goldberg and Myers Dentistry, PLC
• Aaron Jacob Goldfarb, D.O.
• Lauren Byrne Goldie, NP
• Zachary Todd Goldstein, DO
• Aniyah Golson

• Surgery Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.