John Lester Goudreau, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

5101012751 Issued in MI

Practice address

804 Service Rd # A217
East Lansing, MI 48824-7015

Phone

(517) 353-8122

Fax

(517) 432-3713

NPI assigned

Aug 8, 2006

Last updated

Aug 29, 2016By the provider in NPPES

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

Specialty

Neurology

Education

Michigan State University College of Osteopathic Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgoudreau20403@direct.bronsonhg.org
• Direct secure messaging: john.goudreau.1@25394.direct.athenahealth.com

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.

• Msu Health Care Inc

  • Allergy & Immunology Physician
  • East Lansing, MI
  • NPI 1700418670
  Medicare reassignment Care Compare group NPD
• Bronson Methodist Hospital

  dba Bronson Medical Group

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137

  Neurology

  Medicare reassignment NPD
• Michigan State University

  • Diagnostic Radiology Physician
  • East Lansing, MI
  • NPI 1891747614
  Medicare reassignment NPD
• Capital Area Pathologists, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lansing, MI
  • NPI 1417049925
  NPD
• Michigan State University

  dba Michigan State University Extension

  • Local Education Agency (LEA)
  • East Lansing, MI
  • NPI 1184182982
  NPD
• Michigan State University

  • Surgery Physician
  • East Lansing, MI
  • NPI 1699725895
  NPD
• Michigan State University

  • Family Medicine Physician
  • East Lansing, MI
  • NPI 1851470744

  Neurology

  NPD
• Msu Health Care Inc.

  • Physical Therapist
  • East Lansing, MI
  • NPI 1689206419
  NPD
• McLaren Greater Lansing

  • Family Medicine Physician
  • Lansing, MI
  • NPI 1962808162
  NPD (past)
• Michigan State University

  • Family Nurse Practitioner
  • East Lansing, MI
  • NPI 1639253784
  NPD (past)

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

• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  dba Thoracic Cardiovascular Institute

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation
• McLaren Greater Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1134104672
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1477563096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD # A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD # A217",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-8122",
            "fax_number": "517-432-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDREAU",
        "first_name": "JOHN",
        "middle_name": "LESTER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "5101012751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477563096",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4318494",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyla Jane Goolsby
• Zoe Gorman
• Ved V Gossain, M.D.
• Timothy Lynn Goth-Owens, PHD
• Rishika Gottumukala
• Grace Counseling
• Grace Therapy PLLC
• Graceful Hands Doula Care, LLC
• Kellie Grady, LPC
• Ketura Blondelle Lauture Graham

• Neurology Physician in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.