Active NPI
Katrina Anne Godderz, M.D.
- Emergency Medicine Physician
- South Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME 122296
- Practice address
- 6200 SW 73Rd St
South Miami, FL 33143-4679 - Phone
- (786) 662-0455
- NPI assigned
- Aug 8, 2012
- Last updated
- Sep 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD177893 | OR | |
| Emergency Medicine Physician | 207P00000X | ME 122296 | FL | Primary |
Addresses
Primary practice location
6200 SW 73Rd St
South Miami, FL 33143-4679
Mailing address
3250 Grand Ave
Apartment 310
Miami, FL 33133-5016
Phone (509) 315-6319
Other practice location 1
1046 6th Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kgodderz666392@oc.providencedirect.org | ||
| Direct Messaging Address | kgodderz260081@samhealth.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, VI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 94.37 of 100
- Quality
- 92.31
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 80.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 122296 | FL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients | |
| Healogics Specialty Physicians of Oregon, LLC | Emergency Medicine | Current | Accepting new patients |
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients |
Locations
1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000
375 SE Norton Ln
Ste A
McMinnville, OR 97128
Phone (503) 472-5749
875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719
1460 G St
Springfield, OR 97477
Phone (541) 431-0665
4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423
Interoperability endpoints
- kgodderz666392@oc.providencedirect.org
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Christiansted, St. Croix, VI
- NPI 1972503647
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Salem, OR
- NPI 1841664752
Emergency Medicine
-
dba Nep
- Emergency Medicine Physician
- Arlington, WA
- NPI 1235172370
OR
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- St Croix, VI
- NPI 1740238534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1588911614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3250 GRAND AVE",
"address_2": "APARTMENT 310",
"city": "MIAMI",
"state": "FL",
"postal_code": "331335016",
"telephone_number": "509-315-6319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 SW 73RD ST",
"city": "SOUTH MIAMI",
"state": "FL",
"postal_code": "331434679",
"telephone_number": "786-662-0455"
}
],
"practiceLocations": [
{
"address_1": "1046 6th Ave SW",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "OR",
"postal_code": "973211916",
"country_code": "US",
"telephone_number": "541-812-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GODDERZ",
"first_name": "KATRINA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-08",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "MD177893",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME 122296",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kgodderz666392@oc.providencedirect.org",
"affiliation": "N",
"address_1": "725 S Wahanna Rd",
"city": "Seaside",
"state": "OR",
"country_code": "US",
"postal_code": "971387735",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kgodderz260081@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "1046 6th Ave SW",
"city": "Albany",
"state": "OR",
"country_code": "US",
"postal_code": "973211916",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in South Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.
- 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.