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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. SUNITA N GODIWALA M.D., FAAFP.
NPI 1407838188
Family Medicine in Holden, MA

Active since November 17, 2005PECOS Enrolled
11 MAYO DR, UNIT-B, HOLDEN, MA 01520(508) 829-5599 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Sunita N Godiwala M.d., Faafp. NPPES

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

DR. SUNITA N GODIWALA M.D., FAAFP. (NPI 1407838188) is an individual family medicine provider in Holden, Massachusetts, licensed in Massachusetts (58524) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Adcare Hospital Of Worcester Inc, and is a graduate of Other (1981).

NPPES Registry Identity

NPI1407838188
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SUNITA N GODIWALACredential: M.D., FAAFP.
Location Address11 MAYO DR, UNIT-BHolden, MA 01520-1539
Mailing Address11 Mayo Dr, Unit-bHolden, MA 01520-1539 · (508) 829-5599
Phone(508) 829-5599
Sole ProprietorNo
Medical School CMSOtherGraduated 1981
Enumeration DateNovember 17, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1407838188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MA · 58524
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

11 MAYO DR, Holden, MA 01520
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.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

Dr. Sunita N Godiwala M.d., Faafp. 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 ID5698748234
PECOS Enrollment IDI20040812001586
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 8

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
625 services156 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
397 services184 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
124 services77 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
123 services123 patients
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic G2012
A virtual check-in is a short online or phone consultation with your healthcare provider. It's for established patients and isn't related to a recent appointment. It's a convenient way to discuss health concerns without needing to visit the office in person.
97 services59 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
74 services56 patients

Hospital Affiliations CMS Care Compare 3

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

Adcare Hospital Of Worcester Inc

Acute Care Hospitals · Worcester, MA
OwnershipProprietary
CMS Certification Number220062
Location107 Lincoln StreetWorcester, MA 01605 · Worcester County

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Worcester, MA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number220176
Location123 Summer StreetWorcester, MA 01608 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01520 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
100%126 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%4,287 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
79%2,568 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
15%84 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%38 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
74%706 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
96%177 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%193 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%165 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
96%706 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
36%706 patients2/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

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

DR. JOHN DOBBIE SHAW D.D.S.
Dentist (General Practice)
11 MAYO DR
HOLDEN, MA 01520
Worcester County (508) 829-4909
NEIL F CANNON M.D.
Family Medicine
11 MAYO DR
HOLDEN, MA 01520
Worcester County (508) 829-4355
RICHARD J FLEMING PA
Physician Assistant
11 MAYO DR
HOLDEN, MA 01520
Worcester County (508) 829-4355

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 Sunita Godiwala's NPI number?

The NPI number for Sunita Godiwala is 1407838188. It was assigned to this individual provider in the NPPES registry on November 17, 2005.

Where is Sunita Godiwala located?

Sunita Godiwala practices at 11 Mayo Dr Unit-B, Holden, MA 01520. The listed phone number is (508) 829-5599.

What is Sunita Godiwala's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sunita Godiwala enrolled in Medicare?

Yes. Sunita Godiwala is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sunita Godiwala accept?

Health plans from Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Sunita Godiwala as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sunita Godiwala affiliated with any hospitals?

According to CMS data, Sunita Godiwala is affiliated with Adcare Hospital Of Worcester Inc, Umass Memorial Medical Center/University Campus and St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Sunita Godiwala was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.