Individual provider Active NPI

Zachary Todd Goldstein, DO

  • Family Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1457911877
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5151013623 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(517) 230-7543
NPI assigned
Jun 18, 2019
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5151013623 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

Ascension Genesys Hospital
1 Genesys Parkway
Grand Blanc, MI 48439
Phone (517) 230-7543

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
I20220111000257 MI Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5991197675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1701 Lake Lansing Rd
Suite 100
Lansing, MI 48912-3798

1881 W Grand River Ave
Okemos, MI 48864-1840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151013623MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton County Medical Center PC Single Specialty CurrentSince Jun 17, 2023 Accepting new patients
Clinton County Medical Center PC Single Specialty CurrentSince Jun 17, 2023 Accepting new patients
Edward W Sparrow Hospital Association Family Medicine Past Accepting new patients

Locations

10673 E Carson City Rd
Carson City, MI 48811
Phone (989) 584-3153

4185 E Grand River Ave
Howell, MI 48843
Phone (517) 546-9200

1005 S US Highway 27
Ste 100
Saint Johns, MI 48879

Interoperability endpoints

  • Direct secure messaging: zacharygoldstein@ouchuc.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1457911877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ASCENSION GENESYS HOSPITAL",
            "address_2": "1 GENESYS PARKWAY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "48439",
            "telephone_number": "517-230-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "517-230-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "ZACHARY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151013623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.