Vijay Goburdhun, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301031529 Issued in MI

Practice address

14555 Levan Rd Ste 403
Livonia, MI 48154-5085

Phone

(734) 655-1618

Fax

(734) 462-5997

NPI assigned

Dec 8, 2005

Sex

Male

Sole proprietor

No

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• St Mary Mercy Hospital Professional

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1528145554
  Medicare reassignment NPD
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  NPD
• St Mary Mercy Hospital Crna

  • Certified Registered Nurse Anesthetist
  • Livonia, MI
  • NPI 1063602092
  NPD
• St Mary Mercy Hospital Professional

  • Gastroenterology Physician
  • Ypsilanti, MI
  • NPI 1447953971
  NPD

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1275518581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14555 LEVAN RD STE 310",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 LEVAN RD STE 403",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545085",
            "telephone_number": "734-655-1618",
            "fax_number": "734-462-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBURDHUN",
        "first_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301031529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Gloster
• Cynthia Glover
• Kristina Glowski, CRNA
• Steven Robert Gluck, D.D.S.
• Sara Goburdhun, PHD
• Ajey V Godbole, M.D.
• Douglas Goebel, CCP
• Casey Goettlicher
• Victoria Golas, DO
• Rachel Morgan Goldberg

• Internal Medicine Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.