Active NPI
Gillian Rose Goddard, MD
- Surgery Physician
- Boston, MA
National Provider Identifier
1487044517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 285521
- Practice address
- 38 Cranston St Apt 3
Boston, MA 02130-1848 - Phone
- (972) 900-2356
- NPI assigned
- Jan 27, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 285521 | MA | Primary |
| Surgery Physician | 208600000X | 35.134478 | OH |
Addresses
Primary practice location
38 Cranston St Apt 3
Boston, MA 02130-1848
Mailing address
38 Cranston St Apt 3
Boston, MA 02130-1848
Phone (972) 900-2356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 285521 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1487044517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 CRANSTON ST APT 3",
"city": "BOSTON",
"state": "MA",
"postal_code": "021301848",
"telephone_number": "972-900-2356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 CRANSTON ST APT 3",
"city": "BOSTON",
"state": "MA",
"postal_code": "021301848",
"telephone_number": "972-900-2356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODDARD",
"first_name": "GILLIAN",
"middle_name": "ROSE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-27",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "285521",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35.134478",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.