Tasha Lee Godbolt, is a medicare enrolled "Family Medicine - Adult Medicine" physician in Roselle Park, New Jersey. She graduated from medical school in 2023 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Nurse Practitioner Professional Resources and her current practice location is
141 Chestnut St Ste 201, Roselle Park, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(973) 223-2933.
Tasha Lee Godbolt is licensed to practice in New Jersey (license number 0) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457034951.
Physician's Profile
| Full Name | Tasha Lee Godbolt |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 141 Chestnut St Ste 201, Roselle Park, New Jersey |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Tasha Lee Godbolt graduated from medical school in 2023
NPI Data:
- NPI Number: 1457034951
- Provider Enumeration Date: 08/10/2023
- Last Update Date: 02/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 8628421229
- Enrollment ID: I20240131000896
Medical Identifiers
Medical identifiers for Tasha Lee Godbolt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1457034951 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QA0505X | Family Medicine - Adult Medicine | 0 (New Jersey) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Nurse Practitioner Professional Resources | 1951450931 | 12 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tasha Lee Godbolt allows following entities to bill medicare on her behalf.
| Entity Name | Nurse Practitioner Professional Resources |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558516260
PECOS PAC ID: 1951450931
Enrollment ID: O20090521000466 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tasha Lee Godbolt is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Tasha Lee Godbolt,
141 Chestnut St Ste 201,
Roselle Park, NJ 07204-2282
Ph: (973) 223-2933 | Tasha Lee Godbolt,
141 Chestnut St Ste 201,
Roselle Park, NJ 07204-2282
Ph: (973) 223-2933 |
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