MRS. KELLY ANN GODBERSON NP
NPI 1053833962
Nurse Practitioner in Medford, NY

NPI Status: Active since July 12, 2017

Contact Information

3115 HORSEBLOCK RD
MEDFORD, NY
ZIP 11763
Phone: (631) 730-3000

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  • Individual
  • Female
  • Years of Experience 9
  • Nurse Practitioner
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About KELLY GODBERSON

This page provides the complete NPI Profile along with additional information for Kelly Godberson, a provider established in Medford, New York with a medical specialization in Nurse Practitioner and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1053833962 assigned on July 2017. The practitioner's primary taxonomy code is 363L00000X with license number 308240 (NY). The provider is registered as an individual and her NPI record was last updated 9 years ago.

NPI
1053833962
Provider Name
MRS. KELLY ANN GODBERSON NP
Gender
Female
Entity Type
Individual
Location Address
3115 HORSEBLOCK RD MEDFORD, NY 11763
Location Phone
(631) 730-3000
Mailing Address
32 MARLIN RD CENTEREACH, NY 11720
Mailing Phone
(631) 698-2823
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
Yes
Enumeration Date
07-12-2017
Last Update Date
07-12-2017
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A nurse practitioner (NP) like Kelly Godberson is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
308240
License State
NY
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
308240OTHER (01)NYNURSE PRACTIONER LICENSE

Medicare Participation & PECOS Enrollment Status

Kelly Godberson is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Kelly Godberson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1557635927

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20170922003171

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    Urinary catheter anchoring device, adhesive skin attachment, each (HCPCS:A4333)

    1 DME suppliers used 13 Medicare Claims 156 Services Paid

  • DME-Orthotic Devices (DF000N)

    Urinary catheter anchoring device, leg strap, each (HCPCS:A4334)

    1 DME suppliers used 13 Medicare Claims 13 Services Paid

  • DME-Orthotic Devices (DF000N)

    Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)

    1 DME suppliers used 13 Medicare Claims 26 Services Paid

  • DME-Orthotic Devices (DF000N)

    Appliance cleaner, incontinence and ostomy appliances, per 16 oz. (HCPCS:A5131)

    1 DME suppliers used 13 Medicare Claims 13 Services Paid

Durable Medical Equipment

  • DME-Medical/Surgical Supplies (DA000N)

    Tape, non-waterproof, per 18 square inches (HCPCS:A4450)

    2 DME suppliers used 25 Medicare Claims 2720 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Tape, waterproof, per 18 square inches (HCPCS:A4452)

    2 DME suppliers used 23 Medicare Claims 2668 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Collagen based wound filler, dry form, sterile, per gram of collagen (HCPCS:A6010)

    2 DME suppliers used 37 Medicare Claims 1590 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Collagen dressing, sterile, size 16 sq. in. or less, each (HCPCS:A6021)

    1 DME suppliers used 18 Medicare Claims 540 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)

    2 DME suppliers used 67 Medicare Claims 3481 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing (HCPCS:A6197)

    2 DME suppliers used 52 Medicare Claims 2056 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches (HCPCS:A6199)

    2 DME suppliers used 25 Medicare Claims 2700 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6203)

    2 DME suppliers used 37 Medicare Claims 1920 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6209)

    2 DME suppliers used 25 Medicare Claims 437 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6222)

    2 DME suppliers used 50 Medicare Claims 1795 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6237)

    2 DME suppliers used 29 Medicare Claims 887 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6251)

    2 DME suppliers used 33 Medicare Claims 888 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)

    1 DME suppliers used 13 Medicare Claims 970 Services Paid

  • DME-Medical/Surgical Supplies (DA023N)

    Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

    2 DME suppliers used 53 Medicare Claims 8137 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of chemical to stop tissue regrowth in wound

This procedure involves applying a special chemical to a wound to prevent unwanted tissue from growing back. It aids in proper healing by ensuring only healthy tissue regrows. It's a common, safe practice in wound care.

This service was performed 811 times for 33 patients

Established patient custodial care facility, group care, or assisted living visit, typically 15 minutes

This is a routine 15-minute visit for patients residing in care facilities like nursing homes or assisted living. During this visit, healthcare providers review the patient's health, manage medications, and address any concerns or changes in condition. It ensures continuous, quality care.

This service was performed 117 times for 29 patients

Established patient home visit, typically 15 minutes

An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.

This service was performed 136 times for 16 patients

Follow-up nursing facility visit per day, typically 10 minutes

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

This service was performed 1,920 times for 470 patients

Follow-up nursing facility visit per day, typically 15 minutes

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

This service was performed 2,669 times for 871 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 89 times for 49 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 53 times for 37 patients

Nursing facility discharge day management, 30 minutes or less

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

This service was performed 12 times for 12 patients

Replacement of stomach stoma tube

A replacement of a stomach stoma tube is a procedure where your existing tube is removed and a new one is inserted. This helps ensure the tube functions properly, allowing nutrition directly into your stomach. It's a safe, routine process done by healthcare professionals.

This service was performed 17 times for 12 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 11763 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $105.06
  • Minimum New Patient Price $67.4
  • Maximum New Patient Price $203.53
  • Average New Patient Copayment $26.26
  • Minimum New Patient Copayment $16.85
  • Maximum New Patient Copayment $50.88

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $117.62
  • Minimum Established Patient Price $21.66
  • Maximum Established Patient Price $164.45
  • Average Established Patient Copayment $29.4
  • Minimum Established Patient Copayment $5.41
  • Maximum Established Patient Copayment $41.11

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053833962, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
3
Unchanged
Pos 7
3
Doubled → 6
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 8 → 16 → 7 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 1 + 6 + 3 + 6 + 9 + 1 + 2 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1053833962.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Skilled Nursing Facility
3115 HORSEBLOCK RD
MEDFORD, NY 11763
Licensed Practical Nurse
3115 HORSEBLOCK RD
MEDFORD, NY 11763
Speech-Language Pathologist
3115 HORSEBLOCK RD
MEDFORD, NY 11763
Nurse Practitioner (Adult Health)
3115 HORSEBLOCK RD
MEDFORD, NY 11763
Registered Nurse
3115 HORSEBLOCK RD
MEDFORD, NY 11763

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053833962, enumerated as an "individual" on July 12, 2017.

The provider is located at 3115 HORSEBLOCK RD MEDFORD, NY 11763 and the phone number is (631) 730-3000.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.