| Mitchell B Goldstein, MD | |
|
1245 Washington Ave, Detroit Lakes, MN 56501-3905 | |
| (218) 846-2000 | |
| (218) 846-2114 |
| Full Name | Mitchell B Goldstein |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 36 Years |
| Location | 1245 Washington Ave, Detroit Lakes, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497773030 | NPI | - | NPPES |
| 10974 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 35264 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health St Marys - Detroit Lakes | Detroit lakes, MN | Hospital |
| Sanford Medical Center Fargo | Fargo, ND | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sanford Medical Center Fargo | 8426967803 | 1125 |
| Entity Name | Perham Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932113768 PECOS PAC ID: 2264327766 Enrollment ID: O20040216000182 |
| Entity Name | Sanford Medical Center Fargo |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1922303213 PECOS PAC ID: 8426967803 Enrollment ID: O20090529000206 |
| Entity Name | Sanford Medical Center Fargo |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184917924 PECOS PAC ID: 8426967803 Enrollment ID: O20110701000031 |
| Entity Name | St. Joseph's Area Health Services |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1740325919 PECOS PAC ID: 0345146510 Enrollment ID: O20120113000560 |
| Mailing Address | Practice Location Address |
|---|---|
| Mitchell B Goldstein, MD Po Box 5074, Sioux Falls, SD 57117-5074 Ph: () - | Mitchell B Goldstein, MD 1245 Washington Ave, Detroit Lakes, MN 56501-3905 Ph: (218) 846-2000 |
George A Portilla, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Randall J. Bolar, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Shang-yee S Yeh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-844-2347 |