Individual provider Active NPI

Robert Godefroi, M.D.

Preventive Medicine/Occupational Environmental Medicine Physician
Lawrence, MA

National Provider Identifier

1669460994

Registry record updated Nov 19, 2012

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices3
NPI Registry JSON
Other providers in Lawrence, MA
Sources for this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

Section 1128b(4) exclusion effective Jan 19, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry

Primary specialty: Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License: 54774 Issued in MA
Practice address: 500 Merrimack St
Lawrence, MA 01843-1756
Phone: (978) 557-8870
Fax: (978) 557-8856
NPI assigned: Oct 11, 2005
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Preventive Medicine/Occupational Environmental Medicine Physician	2083P0500X	54774	MA	Primary

Addresses

Primary practice location

500 Merrimack St
Lawrence, MA 01843-1756

Mailing address

500 Merrimack St
Lawrence, MA 01843-1756
Phone (978) 557-8870

Other identifiers 14

Identifier	Type	State	Issuer
726397	Other	MA	TUFTS
P00449913	Other	MA	RR MEDICARE
110066074A	Medicaid	MA
1669460994	Other	MA	FALLON COMMUNITY HEALTH PLAN
30201344	Other	NH	NH MEDICAID
974547	Other	MA	NETWORK HEALTH
J04702	Other	MA	BLUE CROSS BLUE SHIELD
424231	Other		HEALTHSOURCE
4572103	Other	MA	AETNANON HMO
35256597	Other		CIGNA
0042049	Other	MA	NEIGHBORHOOD HEALTH PLAN
1669460994	Other	MA	AETNA HMO
6197213	Medicaid	MA
808997	Other	MA	HARVARD PILGRIM HEALTHCAR

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Not enrolled
HHS exclusion list flag: Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials: Doctor of Medicine

Practice roles

Organization	Status	New patients
The Lowell General Hospital	Past	Accepting new patients
LGH Physician Associates, Inc	Past	Accepting new patients
DO Not Use - the Lowell General Hospital	Past	Accepting new patients

Interoperability endpoints

FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

Organizations & group practices 3

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.

DO Not Use - the Lowell General Hospital
- General Acute Care Hospital
- Lowell, MA
- NPI 1013983287
NPD (past)
LGH Physician Associates, Inc
- Family Medicine Physician
- Lowell, MA
- NPI 1972596146
NPD (past)
The Lowell General Hospital
- General Acute Care Hospital
- Lowell, MA
- NPI 1407804669
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1669460994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431756",
            "telephone_number": "978-557-8870",
            "fax_number": "978-557-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431756",
            "telephone_number": "978-557-8870",
            "fax_number": "978-557-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODEFROI",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "MA",
            "license": "54774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "726397",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00449913",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110066074A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH PLAN",
            "identifier": "1669460994",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH MEDICAID",
            "identifier": "30201344",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK  HEALTH",
            "identifier": "974547",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J04702",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "424231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNANON HMO",
            "identifier": "4572103",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "35256597",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0042049",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1669460994",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6197213",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "808997",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.