Rocelious Goodson III, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601004396 Issued in MI

Practice address

4241 Maple St
Suite 200 D
Dearborn, MI 48126-3826

Phone

(313) 584-1940

Fax

(313) 584-1945

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rgoodson1457057@epic00.shdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group
• Preferred Visiting Physicians, PC

  • Medical Physician Assistant
  • Westland, MI
  • NPI 1649592817
  NPD Authorized official
• CC Griggs Holding, LTD.

  • Nephrology Physician
  • Detroit, MI
  • NPI 1114024486
  Medicare reassignment
• Everett V Bryant MD PLLC

  • Family Medicine Physician
  • Dearborn, MI
  • NPI 1306992201
  Medicare reassignment
• Leonard Ellison Jr MD PC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1609821537
  Medicare reassignment
• Nardin Park Recovery Center,Inc.

  • Methadone Clinic
  • Detroit, MI
  • NPI 1033251269
  Medicare reassignment
• Fine Touch Home Care Inc

  • Home Health Agency
  • Southfield, MI
  • NPI 1548335755
  NPD (past)
• Laz Medical Group PC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Southfield, MI
  • NPI 1053310128

  Medical

  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1992863872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5790 NEWBERRY ESTATES DR",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481858300",
            "telephone_number": "313-850-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 MAPLE ST",
            "address_2": "SUITE 200 D",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263826",
            "telephone_number": "313-584-1940",
            "fax_number": "313-584-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "ROCELIOUS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estefany Gonzalez-Magallon
• Karina Gonzalez
• Maria Eliza Gonzalez
• Alayna Good, CF-SLP
• Grace Marie Goodrich
• Richard Michael Goodwin III
• Benjamin Gordon
• Maxwell Gorman
• Allison Gorton
• Alison Elizabeth Gottlob

• Medical Physician Assistant in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.