Individual provider Active NPI

Raymond Goddu, PT

  • Physical Therapist
  • Warwick, RI
National Provider Identifier
1225373533
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02535 Issued in RI
Practice address
535 Centerville Rd
Suite 101
Warwick, RI 02886-4486
Phone
(401) 737-4581
Fax
(401) 737-4811
NPI assigned
Nov 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT02535 RI Primary

Addresses

Primary practice location

535 Centerville Rd
Suite 101
Warwick, RI 02886-4486

Mailing address

535 Centerville Rd
Suite 101
Warwick, RI 02886-4486
Phone (401) 737-4581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130503000051 RI Practitioner - Physical Therapist in Private Practice 5395982755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy LLCGroup PAC ID 1951295187, 73 clinicians

Practice addresses (Care Compare)

535 Centerville Rd
Suite 101
Warwick, RI 02886-4376
Phone (401) 737-4581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy, LLC Physical Therapist CurrentSince Feb 14, 2013 Accepting new patients

Locations

982 Tiogue Ave
Coventry, RI 02816
Phone (401) 615-3140

1412 Atwood Ave
Johnston, RI 02919
Phone (401) 213-8799

535 Centerville Rd
Ste 101
Warwick, RI 02886
Phone (401) 737-4581

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1225373533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD",
            "address_2": "SUITE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864486",
            "telephone_number": "401-737-4581",
            "fax_number": "401-737-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD",
            "address_2": "SUITE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864486",
            "telephone_number": "401-737-4581",
            "fax_number": "401-737-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDU",
        "first_name": "RAYMOND",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (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.