Individual provider Active NPI

Adam R Goff, O.D.

  • Optometrist
  • Kalamazoo, MI
National Provider Identifier
1255643177
Registry record updated Mar 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004627 Issued in MI
Practice address
123 S Westnedge Ave
Kalamazoo, MI 49007-4625
Phone
(517) 303-3652
NPI assigned
Jul 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004627 MI Primary
Optometrist 152W00000X OPT.5943-THER OH

Addresses

Primary practice location

123 S Westnedge Ave
Kalamazoo, MI 49007-4625

Mailing address

PO Box 13
Schoolcraft, MI 49087-0013
Phone (517) 303-3652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110708000433 MI Practitioner - Optometry 8325226640 Reassigns benefits to 2 organizations
I20240424000504 IN Practitioner - Optometry 8325226640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1107 W Broadway St
Suite a
Three Rivers, MI 49093-8376
Phone (269) 244-3350

801 Wayne St
Suite 5
Middlebury, IN 46540-9074
Phone (269) 244-3350

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901004627MIMDOptometrist
OPT.5943-THEROHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Blanc Opthalmology PastSince Oct 4, 2014 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459036800000",
    "number": "1255643177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13",
            "city": "SCHOOLCRAFT",
            "state": "MI",
            "postal_code": "490870013",
            "telephone_number": "517-303-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S WESTNEDGE AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074625",
            "telephone_number": "517-303-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "ADAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2016-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004627",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.5943-THER",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.