Individual provider Active NPI

Gunjan Gholkar, M.D

  • Cardiovascular Disease Physician
  • Wyoming, MI
National Provider Identifier
1386922003
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301104501 Issued in MI
Practice address
2122 Health Dr SW Ste 133
Wyoming, MI 49519-9698
Phone
(616) 252-5950
Fax
(616) 252-5956
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301104501 MI
Internal Medicine Physician 207R00000X 390200200000X CT
Cardiovascular Disease Physician 207RC0000X 4301104501 MI Primary

Addresses

Primary practice location

2122 Health Dr SW Ste 133
Wyoming, MI 49519-9698

Mailing address

5900 Byron Center Ave SW
Medical Administration
Wyoming, MI 49519-9606
Phone (616) 252-3243

Other practice location 1

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170712003277 MI Practitioner - Cardiovascular Disease (Cardiology) 8527358530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

2122 Health Dr SW
Suite 133
Wyoming, MI 49519-9698
Phone (616) 252-5950

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
390200200000XCTMDInternal Medicine Physician
4301104501MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ggholkar69746@direct.metrohealth.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1386922003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 HEALTH DR SW STE 133",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199698",
            "telephone_number": "616-252-5950",
            "fax_number": "616-252-5956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16001 W 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754818",
            "country_code": "US",
            "telephone_number": "248-849-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOLKAR",
        "first_name": "GUNJAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301104501",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "390200200000X",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301104501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.