Irvin D Godofsky, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C34361 Issued in CA

Practice address

4519 Admiralty Way Ste 110
Marina del Rey, CA 90292-5455

Phone

(310) 822-1771

Fax

(310) 822-1771

NPI assigned

Jun 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 22, 2018 through Mar 22, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205864147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 ADMIRALTY WAY STE 110",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925455",
            "telephone_number": "310-822-1771",
            "fax_number": "310-822-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 ADMIRALTY WAY STE 110",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925455",
            "telephone_number": "310-822-1771",
            "fax_number": "310-822-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODOFSKY",
        "first_name": "IRVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C34361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joselyn Gissell Gil
• Robert Joseph Giombetti, M.D.
• Eryn Gitelis
• Glenn Martin Lipton, MD, AMC
• Global DME Inc.
• Herbert Michael Goldberg, M.D.
• Lindsay Mara Goldman, PA
• Max Dean Goldstein, M.D.
• Brenda V Gomez, PA
• Karen Gomez

• Psychiatry Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.