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EDMOND GODBOUT PA
NPI 1710991955
Physician Assistant in Providence, RI

Active since July 27, 2006PECOS Enrolled
97.91/100
CMS Quality Rating
593 EDDY ST, PROVIDENCE, RI 02903(401) 519-1604(401) 272-0538 Get Directions Write a Review

NPPES record last updated: February 19, 2010. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Edmond Godbout Pa NPPES

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

EDMOND GODBOUT PA (NPI 1710991955) is an individual physician assistant in Providence, Rhode Island, licensed in Rhode Island (PA00090) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710991955
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameEDMOND GODBOUTCredential: PA
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing AddressPo Box 9484Providence, RI 02940-9484 · (401) 854-2500 · Fax (401) 854-2519
Phone(401) 519-1604
Fax(401) 272-0538
Sole ProprietorNo
Enumeration DateJuly 27, 2006
Last NPPES UpdateFebruary 19, 2010
✔ NPI 1710991955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in RI · PA00090
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
593 EDDY ST, Providence, RI 02903
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Other Identifiers 8

Medicaid7008105RI
Medicare ID-Type Unspecified007008105RI
Other1710991955Npi
Medicare UPINS66027RI
Other939025129RI · Ri Medicare Group Number
Other01/15/2008RI · Nhpri
Other1962455022RI · Uemf Group Npi
Other04/01/2008RI · Bcbsri

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edmond Godbout 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02903 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
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.

97.91/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.97
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRIAN CAO MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-4286
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695

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 Edmond Godbout's NPI number?

The NPI number for Edmond Godbout is 1710991955. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Edmond Godbout located?

Edmond Godbout practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 519-1604.

What is Edmond Godbout's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Edmond Godbout enrolled in Medicare?

Yes. Edmond Godbout is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Edmond Godbout was last updated on February 19, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.