DAVID THEODORE GOUDREAULT (PA-C) – Medical Physician Assistant, NPI 1215668207
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,091 PHYSICIAN ASSISTANT in MA
Provider Addresses for DAVID THEODORE GOUDREAULT (PA-C)
104 MOORE ST
CHICOPEE, MA 010133404
Phone: (413) 883-3037
Type: Mailing
3455 MAIN ST STE 5
SPRINGFIELD, MA 011071147
Phone: (413) 733-9600
Fax: (413) 732-6534
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $758.
Total Amount is formed as General ($758) + Research ($0) + Ownership ($0) = $758.
Last reported payment date: 2024-11-27 • Largest payer in this snapshot: Janssen Biotech, Inc. ($248).
Total Amount
$758
General + Research + Ownership
Payments
14
Total payment records
General Amount
$758
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Biotech, Inc. | $248 |
| Incyte Corporation | $240 |
| E.R. Squibb & Sons, L.L.C. | $177 |
| SANOFI-AVENTIS U.S. LLC | $80 |
| LEO Pharma Inc. | $13 |
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: 2022-09-29
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 |
|---|---|---|---|---|
| I20220929001312 | I | Physician Assistant | MA | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,312 | 264 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 839 | 644 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 414 | 358 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 405 | 330 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 209 | 189 | $0 |
Insurance plans in this area (ZIP 01013)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MA | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | MA | |
| Physician Assistant | MA | |
| - | NY | |
| D E R M A T O L O G Y | MA | |
| Physician Assistant | MA | |
| Physician Assistant | MA | |
| P A T H O L O G Y | MA | |
| P A T H O L O G Y | MA | |
| D E R M A T O L O G Y | MA |
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