MR. ROCELIOUS III GOODSON (PA-C) – Medical Physician Assistant, NPI 1992863872
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
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Provider Addresses for MR. ROCELIOUS III GOODSON (PA-C)
4241, Maple Street, Dearborn, Wayne County, Michigan, 48126, United States
SUITE 200 D
DEARBORN, MI 481263826
Phone: (313) 584-1940
Fax: (313) 584-1945
Type: Location
5790, Newberry Estates Drive, Newberry Estates, Westland, Wayne County, Michigan, 48185, United States
WESTLAND, MI 481858300
Phone: (313) 850-6552
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $493.
Total Amount is formed as General ($493) + Research ($0) + Ownership ($0) = $493.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Medtronic, Inc. ($196).
Total Amount
$493
General + Research + Ownership
Payments
9
Total payment records
General Amount
$493
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $196 |
| W. L. Gore & Associates, Inc. | $168 |
| Ethicon US, LLC | $90 |
| Boston Scientific Corporation | $39 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-04-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070412000084 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48126)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Hematology/Oncology, Internal Medicine | MI | |
| P S Y C H I A T R Y | MI | |
| - | MI | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI |
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