Individual provider Active NPI

Laiz Laura De Godoy, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1265123285
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD489789 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4206
Phone
(215) 662-3000
Fax
(215) 662-7011
NPI assigned
May 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA12625400 NJ
Diagnostic Radiology Physician 2085R0202X MD489789 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
1 Silverstein
Philadelphia, PA 19104-4206
Phone (215) 662-3000

Other practice location 1

4701 Pine St Apt K10
Philadelphia, PA 19143-1880
Phone (267) 275-2085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250703000980 PA Practitioner - Diagnostic Radiology 7113430968 Reassigns benefits to 1 organization
I20250703001242 NJ Practitioner - Diagnostic Radiology 7113430968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, shared by 7 NPIs, 793 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1006 Mantua Pike
Woodbury, NJ 08097-1221
Phone (856) 686-8282

1865 Route 70 E 130
Rad Cherry Hill
Cherry Hill, NJ 08003-2013
Phone (856) 433-2535

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 615-5858

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC Neuroradiology CurrentSince Jul 1, 2025 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2025 Accepting new patients
University of Penn-Medical Group Neuroradiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

1865 Route 70 E
Ste 130
Cherry Hill, NJ 08003
Phone (856) 433-2535

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-3005

Organizations & group practices 6

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1265123285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "1 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3000",
            "fax_number": "215-662-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3000",
            "fax_number": "215-662-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 Pine St Apt K10",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191431880",
            "country_code": "US",
            "telephone_number": "267-275-2085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE GODOY",
        "first_name": "LAIZ LAURA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA12625400",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD489789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.