Individual provider Active NPI

George Thomas Goffas, MD

  • Plastic Surgery Physician
  • Saint Clair Shores, MI
National Provider Identifier
1982627196
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
4301064416 Issued in MI
Practice address
22631 Greater Mack Ave
Ste 200
Saint Clair Shores, MI 48080-2055
Phone
(586) 773-6900
Fax
(586) 773-5851
NPI assigned
Jul 26, 2006
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 2901014708 MI
Plastic Surgery Physician 208200000X 4301064416 MI Primary

Addresses

Primary practice location

22631 Greater Mack Ave
Ste 200
Saint Clair Shores, MI 48080-2055

Mailing address

22631 Greater Mack Ave
Suite 200
Saint Clair Shores, MI 48080-2055
Phone (586) 773-6900

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
I20110920000769 MI Practitioner - Maxillofacial SurgeryPractitioner - Plastic and Reconstructive Surgery 4486825619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Plastic and Reconstructive Surgery
Education
New York Medical College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22631 Greater Mack Ave
Suite 200
Saint Clair Shores, MI 48080-2055
Phone (586) 773-6900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2901014708MIMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Pointes Plastic Surgery Associates P C Plastic Surgery CurrentSince Jan 1, 1996 Accepting new patients

Locations

22631 Greater Mack Ave
Ste 200
St Clr Shores, MI 48080
Phone (313) 886-8900

Interoperability endpoints

  • Direct secure messaging: ggoffas1130229@direct.hfhs.org
  • Direct secure messaging: ggoffas222599@direct.hfhs.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1982627196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22631 GREATER MACK AVE",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802055",
            "telephone_number": "586-773-6900",
            "fax_number": "586-773-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22631 GREATER MACK AVE",
            "address_2": "STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802055",
            "telephone_number": "586-773-6900",
            "fax_number": "586-773-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFFAS",
        "first_name": "GEORGE",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901014708",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301064416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.