NICKOLAS T GODLEY (PA-C) – Physician Assistant, NPI 1033782248
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for NICKOLAS T GODLEY (PA-C)
PO BOX 117345
ATLANTA, GA 303687345
Phone: (904) 346-3465
Fax: (904) 858-6489
Type: Mailing
1325 SAN MARCO BLVD STE 200
JACKSONVILLE, FL 322078566
Phone: (904) 346-3465
Fax: (904) 396-0388
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $125.
Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.
Last reported payment date: 2024-09-30 • Largest payer in this snapshot: SI-BONE, INC. ($37).
Total Amount
$125
General + Research + Ownership
Payments
5
Total payment records
General Amount
$125
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SI-BONE, INC. | $37 |
| Medtronic, Inc. | $34 |
| Bioventus LLC | $32 |
| ABBVIE INC. | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-11-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221102001486 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 72100 | X-ray of lower and sacral spine, 2-3 views | 99 | 71 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 86 | 62 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 61 | 50 | $0 |
| 22853 | Insertion of cage or mesh device to spine bone and disc space during spine fusion | 49 | 35 | $0 |
| 20939 | Aspiration of bone marrow for spine bone graft | 34 | 34 | $0 |
Insurance plans in this area (ZIP 30368)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| Orthopedic Surgery | FL | |
| Physical Therapist In Private Practice | FL | |
| Physician Assistant | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL |
Reviews
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