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MR. TIMOTHY GODFREY PA
NPI 1689108987
Physician Assistant - Surgical in Wayne, NJ

Active since April 13, 2017PECOS Enrolled
76 WILLOWBROOK BLVD, WAYNE, NJ 07470(862) 246-7938 Get Directions Write a Review

NPPES record last updated: May 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2020, Apr 13, 2017 (2 updates tracked since 2017).

About Mr. Timothy Godfrey Pa NPPES

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

MR. TIMOTHY GODFREY PA (NPI 1689108987) is an individual surgical provider in Wayne, New Jersey, licensed in New Jersey (25MP00560000) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689108987
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. TIMOTHY GODFREYCredential: PA
Location Address76 WILLOWBROOK BLVDWayne, NJ 07470-7002
Mailing Address76 Willowbrook BlvdWayne, NJ 07470-7002 · (862) 246-7938
Phone(862) 246-7938
Sole ProprietorYes
Enumeration DateApril 13, 2017
Last NPPES UpdateMay 19, 20202 updates tracked since enumeration
NPPES CertifiedMay 19, 2020
✔ NPI 1689108987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NJ · 25MP00560000
76 WILLOWBROOK BLVD, Wayne, NJ 07470
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Timothy Godfrey Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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. REBECCA ALTARAS DO
Family Medicine
76 WILLOWBROOK BLVD
WAYNE, NJ 07470
Passaic County (862) 246-7938
DR. CARL GREGORY PUNLA M.D.
Family Medicine
76 WILLOWBROOK BLVD
WAYNE, NJ 07470
Passaic County (862) 246-7938
CITY MEDICAL OF NEW JERSEY, PC
Clinic/Center (Urgent Care)
76 WILLOWBROOK BLVD
WAYNE, NJ 07470
Passaic County (862) 243-7938

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 Timothy Godfrey's NPI number?

The NPI number for Timothy Godfrey is 1689108987. It was assigned to this individual provider in the NPPES registry on April 13, 2017.

Where is Timothy Godfrey located?

Timothy Godfrey practices at 76 Willowbrook Blvd, Wayne, NJ 07470. The listed phone number is (862) 246-7938.

What is Timothy Godfrey's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Timothy Godfrey enrolled in Medicare?

Yes. Timothy Godfrey is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Godfrey was last updated on May 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.