MS. LAUREL GOTHA PA
NPI 1912723826
Physician Assistant in Livonia, MI

Q: What is Laurel Gotha's NPI number?

The NPI number for Laurel Gotha is 1912723826. It was assigned to this individual provider in the NPPES registry on November 25, 2024.

Q: What is Laurel Gotha's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Laurel Gotha was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 25, 2024PECOS EnrolledAccepts Medicare Assignment

14555 LEVAN RD STE 311, SUITE 311, LIVONIA, MI 48154(734) 655-2692(734) 655-4218 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Ms. Laurel Gotha Pa NPPES

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

MS. LAUREL GOTHA PA (NPI 1912723826) is an individual physician assistant in Livonia, Michigan, licensed in Michigan (5601012980) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS, is affiliated with St Joe Mercy Hospital System Livonia, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1912723826

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. LAUREL GOTHACredential: PA

Location Address14555 LEVAN RD STE 311, SUITE 311Livonia, MI 48154

Mailing Address24 Frank Lloyd Wright Drive, Suite J2000Ann Arbor, MI 48105 · (734) 747-6766 · Fax (734) 222-3100

Phone(734) 655-2692

Fax(734) 655-4218

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateNovember 25, 2024

Last NPPES UpdateOctober 21, 2025

NPPES CertifiedOctober 21, 2025

✔ NPI 1912723826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MI · 5601012980

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

14555 LEVAN RD STE 311, Livonia, MI 48154

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Laurel Gotha Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587187471

PECOS Enrollment IDI20251020001355

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joe Mercy Hospital System Livonia

Acute Care Hospitals · Livonia, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230002

Location36475 Five Mile RoadLivonia, MI 48154 · Wayne County

Emergency services Birthing friendly

Promedica Monroe Regional Hospital

Acute Care Hospitals · Monroe, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230099

Location718 N Macomb StMonroe, MI 48162 · Monroe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48154 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

CHRISTINA MARIE SALICE PA-C

Surgery (Surgical Critical Care)