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

Active since July 12, 2017PECOS Enrolled
3115 HORSEBLOCK RD, MEDFORD, NY 11763(631) 730-3000 Get Directions Write a Review

NPPES record last updated: July 12, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Kelly Ann Godberson Np NPPES

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

MRS. KELLY ANN GODBERSON NP (NPI 1053833962) is an individual nurse practitioner in Medford, New York, licensed in New York (308240) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1053833962
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. KELLY ANN GODBERSONCredential: NP
Location Address3115 HORSEBLOCK RDMedford, NY 11763-2526
Mailing Address32 Marlin RdCentereach, NY 11720-3012 · (631) 698-2823
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 12, 2017
NPI 1053833962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in NY · 308240
Definition
(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.
3115 HORSEBLOCK RD, Medford, NY 11763

Other Identifiers 1

Other308240NY · Nurse Practioner License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mrs. Kelly Ann Godberson Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557635927
PECOS Enrollment IDI20170922003171
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.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
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.
5,942 services1,014 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
997 services896 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
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.
707 services390 patients
Application of chemical to stop tissue regrowth in wound 17250
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.
609 services40 patients
Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99304
An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.
117 services113 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
56 services31 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11763 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 18

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Urinary catheter anchoring device, adhesive skin attachment, each A4333
DME-Orthotic Devices · category DF000N
1 supplier13 claims156 services$1.98 avg. paid by Medicare
Urinary catheter anchoring device, leg strap, each A4334
DME-Orthotic Devices · category DF000N
1 supplier13 claims13 services$4.40 avg. paid by Medicare
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358
DME-Orthotic Devices · category DF000N
1 supplier13 claims26 services$5.24 avg. paid by Medicare
Tape, non-waterproof, per 18 square inches A4450
DME-Medical/Surgical Supplies · category DA000N
2 suppliers25 claims2,720 services$0.10 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
2 suppliers23 claims2,668 services$0.37 avg. paid by Medicare
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. A5131
DME-Orthotic Devices · category DF000N
1 supplier13 claims13 services$14.15 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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

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 Kelly Godberson's NPI number?

The NPI number for Kelly Godberson is 1053833962. It was assigned to this individual provider in the NPPES registry on July 12, 2017.

Where is Kelly Godberson located?

Kelly Godberson practices at 3115 Horseblock Rd, Medford, NY 11763. The listed phone number is (631) 730-3000.

What is Kelly Godberson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kelly Godberson enrolled in Medicare?

Yes. Kelly Godberson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Godberson was last updated on July 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.