NPIMap

Individual provider Active NPI

Thomas D Godleski, D.O.

  • Family Medicine Physician
  • Lumberton, NJ
National Provider Identifier
1235168709
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB07019700 Issued in NJ
Practice address
1613 Route 38
Lumberton, NJ 08048-2921
Phone
(609) 261-3716
Fax
(609) 261-5507
NPI assigned
Jun 30, 2006
Last updated
Oct 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB07019700 NJ Primary

Addresses

Primary practice location

1613 Route 38
Lumberton, NJ 08048-2921

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340

Other identifiers 1

IdentifierTypeStateIssuer
0052850MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgodleski14043@directvirtua.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512000141 NJ Practitioner - Family Practice 4789712712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine CurrentSince Jul 1, 2010 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 1, 2010 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Virtua Medical Group, PA Family Medicine Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1613 Route 38
Lumberton, NJ 08048
Phone (609) 261-3716

1613 Route 38
Fl 1
Lumberton, NJ 08048
Phone (609) 444-5566

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

Interoperability endpoints

  • Direct secure messaging: tgodleski14043@directvirtua.org

Organizations & group practices 10

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

Hospital & facility affiliations 10

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1235168709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-355-0340",
            "fax_number": "856-355-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482921",
            "telephone_number": "609-261-3716",
            "fax_number": "609-261-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODLESKI",
        "first_name": "THOMAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB07019700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052850",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgodleski14043@directvirtua.org",
            "affiliation": "N",
            "address_1": "1613 Route 38",
            "city": "Lumberton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080482921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

Verify at the official NPI Registry.