Mallory A Goldman, AGACNP-BC, DNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704327448 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone

(313) 916-2600

NPI assigned

Jul 29, 2022

Last updated

Oct 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgoldman253416@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health System

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1104900455
  Medicare reassignment Care Compare group NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Macomb Health Center Chesterfield

  • Nurse Practitioner
  • Chesterfield, MI
  • NPI 1952440521
  Medicare reassignment NPD
• Henry Ford Wyandotte Hospital

  • Obstetrics & Gynecology Physician
  • Wyandotte, MI
  • NPI 1457586646
  Medicare reassignment NPD
• Wa Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Macomb Hospital Corporation

  • Neonatal Nurse Practitioner
  • Clinton Township, MI
  • NPI 1912301094
  NPD
• Henry Ford Wyandotte Hospital

  • Nurse Practitioner
  • Trenton, MI
  • NPI 1144634403
  NPD
• Henry Ford Wyandotte Hospital

  dba Henry Ford Health Center-Brownstown Pharmacy

  • Community/Retail Pharmacy
  • Brownstown TWP, MI
  • NPI 1356356984
  NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347

  Acute Care

  NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• Henry Ford Maplegrove Center

  dba Henry Ford Health System

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1124754320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "MALLORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "AGACNP-BC, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704327448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Goldgraben, M.D.
• Allison Goldin, M.D.
• Dave Goldman, M.S.W.
• David J. Goldman, M.D.
• Erica Jean Goldman, PA-C
• Jazlyn Chante Goldsmith
• Alexander Goldstein, MSW
• Eric Goldstein, MD
• Gary Neil Goldstein, MA LLP
• Sidney Goldstein, M.D.

• Acute Care Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.