Active NPI
Vasso G Godiali, MD
- Vascular Surgery Physician
- Bay City, MI
National Provider Identifier
1861572000
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 20, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- VG065556
- Practice address
- 2010 15TH St
Bay City, MI 48708 - Phone
- (989) 893-8361
- Fax
- (989) 893-3528
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | VG065556 | MI | Primary |
Addresses
Primary practice location
2010 15TH St
Bay City, MI 48708
Mailing address
2010 15TH St
Bay City, MI 48708
Phone (989) 893-8361
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11277067 | Other | MI | CAQH |
| 0200910161 | Other | MI | BCBS |
| 4540351 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VG065556 | MI | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1861572000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 15TH ST",
"city": "BAY CITY",
"state": "MI",
"postal_code": "48708",
"telephone_number": "989-893-8361",
"fax_number": "989-893-3528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 15TH ST",
"city": "BAY CITY",
"state": "MI",
"postal_code": "48708",
"telephone_number": "989-893-8361",
"fax_number": "989-893-3528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODIALI",
"first_name": "VASSO",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MI",
"license": "VG065556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11277067",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0200910161",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4540351",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bay City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.