Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tasha Lee Godbolt

Individual provider Adult Medicine Physician · NPI 1457034951

Tasha Lee Godbolt is a Nurse Practitioner in Roselle Park, New Jersey. Qualified in 2023, 3 years ago. Practices with Nurse Practitioner Professional Resources, a 13-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
3
Licensed in
NJ
In the registry since
2023

Practice location Address checks out

141 Chestnut St Ste 201
Roselle Park, NJ 07204-2282
Phone: (973) 223-2933
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X · Licence 0 (NJ)

Record details

NPI number1457034951
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 10, 2023
Last updated in NPPESFebruary 26, 2024
Certification dateFebruary 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Nurse Practitioner Professional Resources — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services