Individual provider Active NPI

Kishendra Gopaul, MD

  • Diagnostic Radiology Physician
  • Wyoming, MI
National Provider Identifier
1477079903
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301513857 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7159
NPI assigned
Aug 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301513857 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7159

Other practice location 1

4055 Cascade Rd SE
Grand Rapids, MI 49546-2149
Phone (616) 252-7159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240709003876 MN Practitioner - Diagnostic Radiology 6204180532 Reassigns benefits to 1 organization
I20250708004361 MI Practitioner - Diagnostic Radiology 6204180532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
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)

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301513857MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Aug 1, 2025 Accepting new patients
Mayo Clinic Current Accepting new patients
Metropolitan Hospital CurrentSince Aug 1, 2025 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2024 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2024 Accepting new patients
Northshore Lij Forest Hills Past Accepting new patients

Locations

4055 Cascade Rd SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 252-4010

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

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

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: kgopaul24923@albanymed.direct-ci.com

Organizations & group practices 6

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 1

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": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1477079903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Cascade Rd SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495462149",
            "country_code": "US",
            "telephone_number": "616-252-7159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOPAUL",
        "first_name": "KISHENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301513857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.