Jayaprakash Ayillath Gosalakkal, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

4301104329 Issued in MI

Practice address

7633 E Jefferson Ave
Ste 270
Detroit, MI 48214

Phone

(313) 499-1282

Fax

(313) 499-1324

NPI assigned

May 10, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1669764627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE",
            "address_2": "STE 270",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48214",
            "telephone_number": "313-499-1282",
            "fax_number": "313-499-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7633 E JEFFERSON AVE",
            "address_2": "STE 270",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48214",
            "telephone_number": "313-499-1282",
            "fax_number": "313-499-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSALAKKAL",
        "first_name": "JAYAPRAKASH",
        "middle_name": "AYILLATH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-098366",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A 74084",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A 74084",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OH",
            "license": "35-098366",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MI",
            "license": "4301104329",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MI",
            "license": "4301104329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSURE",
            "identifier": "35-098366",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Maria Gorski, LLMSW
• Michele Renee Gorski, M.S., PA-C
• Teresa A. Gorski, D.D.S.
• Samantha Gorton
• Rohit Goru, MD
• Andrew Goschka, MD
• Goshen Pharmacy LLC
• Gospel Against AIDS Inc
• Bernard Goss Jr., RN
• Elizabeth Goss, PH.D.

• Neurology with Special Qualifications in Child Neurology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.