Peter Godleski, M.D. – Orthopaedic Surgery Physician

Key facts

NPI: 1194750893
Entity type: Individual (NPI type 1)
Primary specialty: Orthopaedic Surgery Physician 207X00000X
License: ME0053893 (FL)
Practice address: 7300 Sand Lake Commons Blvd
Medplex a Suite 312
Orlando, FL 32819-8050
Phone: (321) 222-4152
Fax: (407) 574-8233
NPI assigned: Jul 11, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 3

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.

Metro Orthopedic Specialists, LLC Orthopaedic Surgery Physician · Orlando, FL · NPI 1316577638

NPD Authorized official ORTHOPAEDIC SURGERY
Campbell Clinic, PC Orthopaedic Surgery Physician · Germantown, TN · NPI 1003835141

NPD (past) ORTHOPAEDIC SURGERY
CC Bpci PLC Orthopaedic Surgery Physician · Germantown, TN · NPI 1881387330

NPD (past) ORTHOPAEDIC SURGERY

Medicare Care Compare profile

Specialty: Orthopedic Surgery
Education: Temple University School of Medicine, 1983
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7300 Sand Lake CMN
Suite 312
Orlando, FL 32819-8050
Phone (321) 222-4152

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20111104000665	FL	Practitioner - Orthopedic Surgery	1658567441	Practice locations: Orlando, FL

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
ME0053893	FL	MD	Orthopaedic Surgery Physician

Practice roles

Organization	Specialty	Status	New patients
Metro Orthopedic Specialists, LLC	Orthopaedic Surgery	Current since Feb 2, 2020	Accepting new patients
CC Bpci PLC	Orthopaedic Surgery	Past	Accepting new patients
Campbell Clinic, PC	Orthopaedic Surgery	Past	Accepting new patients

Locations

7300 Sandlake Commons Blvd
Ste 312
Orlando, FL 32819
Phone (321) 222-4152

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Orthopaedic Surgery Physician	207X00000X	46334	TN
Orthopaedic Surgery Physician	207X00000X	ME0053893	FL	Yes

Addresses

Primary practice location

7300 Sand Lake Commons Blvd
Medplex a Suite 312
Orlando, FL 32819-8050

Mailing address

7300 Sand Lake Commons Blvd
Medplex a Suite 312
Orlando, FL 32819-8050
Phone (850) 517-7330

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 23, 2020.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1194750893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 SAND LAKE COMMONS BLVD",
            "address_2": "MEDPLEX A SUITE 312",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198050",
            "telephone_number": "850-517-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 SAND LAKE COMMONS BLVD",
            "address_2": "MEDPLEX A SUITE 312",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198050",
            "telephone_number": "321-222-4152",
            "fax_number": "407-574-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODLESKI",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "46334",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0053893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

All providers in Orlando, FL · Orthopaedic Surgery Physician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.