Stacey Michelle Goodman, MSN, RN, ANP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704243269 Issued in MI

Practice address

441 S Livernois Rd Ste 100
Rochester Hills, MI 48307-2585

Phone

(248) 608-8800

NPI assigned

Nov 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Joel L Young MD PCGroup PAC ID 3971575929, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

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.

• Joel L. Young, M.D., P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester Hills, MI
  • NPI 1396753729
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1417258963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 S LIVERNOIS RD STE 100",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072585",
            "telephone_number": "248-608-8800",
            "fax_number": "248-608-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 S LIVERNOIS RD STE 100",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483072585",
            "telephone_number": "248-608-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704243269",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704243269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosalyn S Goldberg, MA, LLP
• Theodore Alfred Paul Golden, M.D.
• Sarah Margaret Cardy Goncalves, PT, DPT
• Osvaldo Israel Gonzalez Osorio
• Good Plan Homecare LLC
• Victor Henry-Loch Gordon, MD
• George A. Gorgis, PHARMACIST
• Jawan Gorgis, MD
• Shannon Rene Goris, LPC
• Rani Goriyo

• Psychiatric/Mental Health Nurse Practitioner in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.