Stacey Lynn Godman, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP010635 Issued in PA

Practice address

12 Gill St
Woburn, MA 01801-1765

Phone

(781) 939-7397

NPI assigned

Dec 4, 2009

Last updated

Dec 9, 2009By 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 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivx Health of New Jersey, P.C.Group PAC ID 1456898956, 13 clinicians

Infusion Express of Pennsylvania PLLCGroup PAC ID 3678852282, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Infusion Express of Pennsylvania PLLC

  dba IVX Health

  • Infusion Therapy Clinic/Center
  • Malvern, PA
  • NPI 1184179236
  Medicare reassignment Care Compare group NPD
• Ivx Health of New Jersey, P.C.

  dba IVX Health

  • Clinic/Center
  • Paramus, NJ
  • NPI 1285404731
  Medicare reassignment Care Compare group NPD
• Quincy Medical Center

  dba Hospitalist Physicians at Quincy Medical Center

  • Surgical Physician Assistant
  • Quincy, MA
  • NPI 1962446021
  NPD (past)

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1689902595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 BRADFORD CT",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604810",
            "telephone_number": "610-935-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GILL ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011765",
            "telephone_number": "781-939-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODMAN",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010635",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN546954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn a Ruhl, DPM, PC
• Catherine Glenn, PHD
• Global Health Care Services
• Ariana Glyde, AUD
• Allison Godbout, PT
• Deborah Goldberg, OTR/L
• Beth Golden, LMHC
• Marcy Goldsmith, PHD OTRL
• Carri R Goldstein, DC
• Zoey Noelle Gollinger

• Nurse Practitioner in Woburn, MA
• Providers in Woburn, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.

Verify at the official NPI Registry.