Tasha Lee Godbolt

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Practice address

141 Chestnut St Ste 201
Roselle Park, NJ 07204-2282

Phone

(973) 223-2933

NPI assigned

Aug 10, 2023

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nurse Practitioner Professional ResourcesGroup PAC ID 1951450931, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promise Care NJ Home health agency, West New York, NJ, CCN 317064
• Promise Care NJ Home health agency, East Orange, NJ, CCN 317009
• Bayada Home Health Care Inc Home health agency, North Bergen, NJ, CCN 317050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26288/brand/1/csg/1/fhir/r4
• Direct secure messaging: tasha.godbolt.1@26288.direct.athenahealth.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Faith Hospice Care LLC

  dba Faith Hospice Care

  • Community Based Hospice Care Agency
  • Fairfield, NJ
  • NPI 1003695370

  W-2 Managing Employee

  CMS ownership

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.

• Nurse Practitioner Professional Resources

  • Adult Health Nurse Practitioner
  • Blackwood, NJ
  • NPI 1558516260
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • North Bergen, NJ
  • NPI 1982921433
  Care Compare affiliation
• Promise Care of Essex County LLC

  dba Promise Care NJ

  • Home Health Agency
  • East Orange, NJ
  • NPI 1962983379
  Care Compare affiliation
• Promise Care of Hudson County LLC

  dba Promise Care NJ

  • Home Health Agency
  • West New York, NJ
  • NPI 1194206516
  Care Compare affiliation

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1457034951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 CHESTNUT ST STE 201",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042282",
            "telephone_number": "973-223-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 CHESTNUT ST STE 201",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042282",
            "telephone_number": "973-223-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBOLT",
        "first_name": "TASHA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo Garcia
• Garden State Dental Associates, LLC
• Joel C Gelbman, DDS
• Bindu P George
• Richard Edwin Glass, D.C.
• Manuel Alcides Gonzalez, DDS
• Zaira Gonzalez
• Hada Care LLC
• Harmony Smiles LLC
• Diego Alberto Herrera Figueira, M.D.

• Adult Medicine Physician in Roselle Park, NJ
• Providers in Roselle Park, NJ by specialty
• Adult Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.