Individual provider Active NPI

Kyle J Godfrey, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • New York, NY
National Provider Identifier
1104268994
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
287321 Issued in NY
Practice address
1305 York Ave FL 12
New York, NY 10021-5663
Phone
(646) 962-2020
NPI assigned
Jul 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X A132536 CA
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 287321 NY Primary

Addresses

Primary practice location

1305 York Ave FL 12
New York, NY 10021-5663

Mailing address

1305 York Ave
11TH Floor
New York, NY 10021-5663

Other practice location 1

36 Worth St
New York, NY 10013-2903
Phone (646) 962-2020

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address kyg9004@med.cornell.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170710001733 NY Practitioner - Ophthalmology 2668765207 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Georgetown University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1305 York Ave
Suite 11
New York, NY 10021-5663
Phone (646) 962-2020

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A132536CAMDOphthalmic Plastic and Reconstructive Surgery Physician
287321NYMDOphthalmic Plastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Aug 10, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Ophthalmology CurrentSince Jul 1, 2017 Accepting new patients
Weill Medical College of Cornell Ophthalmology CurrentSince Jul 1, 2017 Accepting new patients
Kings Physician Services, PC CurrentSince Aug 10, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Ophthalmology CurrentSince Apr 1, 2018 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2017 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

506 6th St
Fl 6
Brooklyn, NY 11215
Phone (718) 780-5130

51 W 51st St
Ste 360
New York, NY 10019
Phone (212) 326-8415

1305 York Ave
Fl 11
New York, NY 10021
Phone (646) 962-2020

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

1305 York Ave
Fl 12
New York, NY 10021
Phone (646) 962-6200

635 W 165th St
New York, NY 10032
Phone (212) 305-3039

1305 York Ave
#11
New York, NY 10021
Phone (646) 962-2020

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: kyg9004@direct.nyp.org
  • Direct secure messaging: kgodfrey68902@northwell.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1104268994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE",
            "address_2": "11TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 Worth St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100132903",
            "country_code": "US",
            "telephone_number": "646-962-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "KYLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A132536",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "287321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1305 York Ave Fl 12",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100215663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1305 York Ave Fl 12",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100215663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyg9004@med.cornell.edu",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "1305 York Ave Fl 12",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100215663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.