NPIMap

Organization Active NPI

West Michigan Ophthalmology, PC

  • Ophthalmology Physician
  • Muskegon, MI
National Provider Identifier
1912083759
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301079878 Issued in MI
Legal business name
WEST MICHIGAN OPHTHALMOLOGY, PC
Practice address
1150 E Sherman Blvd
Suite 1500
Muskegon, MI 49444-1871
Phone
(231) 737-9378
Fax
(231) 737-1023
NPI assigned
Oct 27, 2006
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Dr. David A Goran, MDNPI 1265544969
Title
Owner
Phone
(231) 737-9378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301079878 MI Primary

Addresses

Primary practice location

1150 E Sherman Blvd
Suite 1500
Muskegon, MI 49444-1871

Mailing address

1150 E Sherman Blvd
Suite 1500
Muskegon, MI 49444-1871
Phone (231) 737-9378

Other identifiers 2

IdentifierTypeStateIssuer
104960267MedicaidMI
1806111162OtherMIBCBSM PIN

National Provider Directory

National Provider Directory

Locations

2094 Momentum Pl
Chicago, IL 60689

1150 E Sherman Blvd
Ste 1500
Muskegon, MI 49444
Phone (231) 733-1098

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1912083759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD",
            "address_2": "SUITE 1500",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441871",
            "telephone_number": "231-737-9378",
            "fax_number": "231-737-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD",
            "address_2": "SUITE 1500",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441871",
            "telephone_number": "231-737-9378",
            "fax_number": "231-737-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MICHIGAN OPHTHALMOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "GORAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-737-9378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301079878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104960267",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "1806111162",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.