DR. EZRA RAE GOODRICH MD
NPI 1851094726
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since March 22, 2023PECOS Enrolled
2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600 Get Directions Write a Review

NPPES record last updated: March 22, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Ezra Rae Goodrich Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EZRA RAE GOODRICH MD (NPI 1851094726) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851094726
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. EZRA RAE GOODRICHCredential: MD
Location Address2799 W GRAND BLVDDetroit, MI 48202-2608
Mailing Address2799 W Grand BlvdDetroit, MI 48202-2608 · (313) 916-2600
Sole ProprietorNo
Enumeration DateMarch 22, 2023
NPPES CertifiedMarch 22, 2023
NPI 1851094726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2799 W GRAND BLVD, Detroit, MI 48202

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Ezra Rae Goodrich Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

General Acute Care Hospital
2799 W GRAND BLVD
DETROIT, MI 48202
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Family Medicine
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Cardiovascular Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ezra Goodrich's NPI number?

The NPI number for Ezra Goodrich is 1851094726. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Ezra Goodrich located?

Ezra Goodrich practices at 2799 W Grand Blvd, Detroit, MI 48202. The listed phone number is (313) 916-2600.

What is Ezra Goodrich's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ezra Goodrich enrolled in Medicare?

Yes. Ezra Goodrich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ezra Goodrich was last updated on March 22, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.