Kristopher Joseph Sean Goddard, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

OS10979 Issued in FL

Practice address

3915 Biscayne Blvd Ste 406
Miami, FL 33137-3737

Phone

(305) 367-1176

Fax

(877) 391-0039

NPI assigned

Nov 2, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 4, 2016 through May 4, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Osteopathic Regenerative Medicine Center, LLC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Miami, FL
  • NPI 1629564463
  NPD Authorized official
• Osteopathic Center PLLC

  • Sports Medicine (Family Medicine) Physician
  • Knoxville, TN
  • NPI 1104236421
  NPD (past) Authorized official
• Osteopathic Center, LLC

  • Sports Medicine (Family Medicine) Physician
  • Miami, FL
  • NPI 1568883536
  NPD

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1780910364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 BISCAYNE BLVD STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373737",
            "telephone_number": "305-367-1176",
            "fax_number": "877-391-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BISCAYNE BLVD STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373737",
            "telephone_number": "305-367-1176",
            "fax_number": "877-391-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "KRISTOPHER",
        "middle_name": "JOSEPH SEAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-02",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS10979",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TN",
            "license": "2081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0045L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shivani Goberdhan
• Allyson Natalie Gobus, APRN
• Allan Gabriel Gochin
• Godabba Services LLC
• Giselle Godals Gocende
• Kamar Godder, M.D.
• Joshua Godefoy, PHARMD
• Lilian Maria Godeiro Coelho, MD
• Delkys Godines Socarras
• Obdaniel Godines

• Sports Medicine (Family Medicine) Physician in Miami, FL
• Providers in Miami, FL by specialty
• Sports Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.