DR. MANISHA GODBOLE (AU.D.) – Audiologist, NPI 1053538819

DR. MANISHA GODBOLE (AU.D.) is a healthcare provider. based in Liberty twp, Ohio. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AU.D.. They hold a License No. A-01433 (OH). The NPI Number for DR. MANISHA GODBOLE (AU.D.) is 1053538819

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
DR. MANISHA GODBOLE (AU.D.)
NPI
1053538819
Phone
Not provided
Address
4625 STONEHAVEN DR
Enumeration Date
20 April 2007
Last Update Date
12 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5134204678
Graduation Year
2007 (19 years ago)
PAC ID
9830611797
Group Practice PAC ID
8921022260
Professional Enrollment ID
I20250320000365
Address ID
OH450423464MI1055XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

412 QUALIFIED AUDIOLOGIST in OH

Provider Addresses for DR. MANISHA GODBOLE (AU.D.)

  • 4625 STONEHAVEN DR

    LIBERTY TWP, OH 450116614

    Phone:

    Type: Mailing

  • 1055 Summit Dr

    Middletown, OH 450423464

    Phone: (513) 420-4678

    Fax: (513) 420-4705

    Type: Location

  • 8439 Yankee St

    Centerville, OH 454581832

    Phone: (937) 312-9368

    Fax: (937) 440-7874

    Type: Location

  • 3170 KETTERING BLVD BLDG B2ND

    MORAINE, OH 454391924

    Phone: (937) 991-3188

    Type: Mailing

  • 369 W 1ST ST

    SUITE 406

    DAYTON, OH 454023095

    Phone: (937) 222-0022

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-03-20

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250320000365IQualified AudiologistOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45011)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921022260View full group profile
NameSpecialtyState
Nurse PractitionerOH
Mental Health CounselorOH
-OH
O T O L A R Y N G O L O G YOH
Orthopedic SurgeryOH
O T O L A R Y N G O L O G YOH
Qualified AudiologistOH
-OH
Mental Health CounselorOH
General SurgeryOH

Reviews

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Frequently asked questions

Is DR. MANISHA GODBOLE (AU.D.) listed with a National Provider Identifier?
Yes — DR. MANISHA GODBOLE (AU.D.) has NPI 1053538819 on file in the registry.
Is there an active status for DR. MANISHA GODBOLE (AU.D.)?
For scheduling context, DR. MANISHA GODBOLE (AU.D.) is shown as active in the registry.
What kind of doctor is DR. MANISHA GODBOLE (AU.D.)?
DR. MANISHA GODBOLE (AU.D.) is associated with Audiologist in the directory — Clinical services aligned with this taxonomy classification.
Where in Ohio is DR. MANISHA GODBOLE (AU.D.) registered?
Use Liberty Twp, Ohio as the headline location for DR. MANISHA GODBOLE (AU.D.) here.
When was this NPI issued?
Enumeration for DR. MANISHA GODBOLE (AU.D.) is noted as April 20, 2007 where the registry provides it.

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