Jeffrey Howard Goldman, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301095691 Issued in MI

Practice address

4100 Park Forest Dr.
Suite 208
Traverse City, MI 49684

Phone

(231) 935-5710

Fax

(231) 935-9045

NPI assigned

Sep 29, 2006

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

Other identifiers 2

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

State licenses

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.

• Digestive Health Associates of Northern Michigan, P.C.

  • Gastroenterology Physician
  • Traverse City, MI
  • NPI 1225104011
  Medicare reassignment NPD
• Olympia Fields Internal Medicine

  • Family Medicine Physician
  • Flossmoor, IL
  • NPI 1336170844
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1316039142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR.",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842058",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR.",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "JEFFREY",
        "middle_name": "HOWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301095691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0280037",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316039142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Gobaleza
• Lydia Michelle Reva Goddard
• Michael Goddard
• Carrie Gold, MED BCBA
• Michael Adam Gold, NP
• Allison Margery Goldsmith
• Gail Goldsmith, LBSW
• Tana Rae Golembiewski, RDH
• Good Harbor Therapy, LLC
• Don A Good, MD

• Gastroenterology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.