Individual provider Active NPI

Carlos Manuel Godinez Rodriguez, MD

  • Family Medicine Physician
  • Pontiac, MI
National Provider Identifier
1639969660
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351054674 Issued in MI
Practice address
461 W Huron St Ste 107
Pontiac, MI 48341-1601
Phone
(248) 724-7600
Fax
(248) 857-7141
NPI assigned
May 12, 2025
Last updated
May 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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 4351054674 MI Primary

Addresses

Primary practice location

461 W Huron St Ste 107
Pontiac, MI 48341-1601

Mailing address

PO Box 430150
Pontiac, MI 48343-0150
Phone (248) 724-7600

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
I20260406001044 MI Practitioner - Family Practice 4486129756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 430150
Pontiac, MI 48343

PO Box
Suite 5478
Pawtucket, RI 02862-5478

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351054674MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Healthcare Network Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carlos.godinezrodriquez.p1@direct.oihn.nextgenshare.com

Organizations & group practices 2

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": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1639969660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430150",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483430150",
            "telephone_number": "248-724-7600",
            "fax_number": "248-857-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST STE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-724-7600",
            "fax_number": "248-857-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODINEZ RODRIGUEZ",
        "first_name": "CARLOS",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351054674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.