Individual provider Active NPI

Michael Jay Goldstein, M.D.

  • Occupational Medicine Physician
  • Pontiac, MI
National Provider Identifier
1508158759
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
4301055488 Issued in MI
Practice address
1251 Joslyn Ave
483-109-750
Pontiac, MI 48340-2064
Phone
(248) 857-3524
NPI assigned
May 6, 2011
Last updated
Feb 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 4301055488 MI Primary

Addresses

Primary practice location

1251 Joslyn Ave
483-109-750
Pontiac, MI 48340-2064

Mailing address

2667 Birch Harbor LN
483-109-750
West Bloomfield, MI 48324-1905
Phone (248) 568-3260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301055488MIMDOccupational Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1508158759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2667 BIRCH HARBOR LN",
            "address_2": "483-109-750",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483241905",
            "telephone_number": "248-568-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 JOSLYN AVE",
            "address_2": "483-109-750",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483402064",
            "telephone_number": "248-857-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-06",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MI",
            "license": "4301055488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.