Individual provider Active NPI

Daniel Bodmer, M.D.

  • Vascular & Interventional Radiology Physician
  • New York, NY
National Provider Identifier
1023462975
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
D0096646 Issued in MD
Practice address
615 E 14TH St
Apt 7C
New York, NY 10009-3210
Phone
(443) 602-4273
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X D0096646 MD Primary

Addresses

Primary practice location

615 E 14TH St
Apt 7C
New York, NY 10009-3210

Mailing address

615 E 14TH St
Apt 7C
New York, NY 10009-3210
Phone (443) 602-4273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230322000350 VA Practitioner - Diagnostic Radiology 9537533104 Reassigns benefits to 1 organization
I20230410000009 MD Practitioner - Diagnostic Radiology 9537533104 Reassigns benefits to 1 organization
I20230410000013 DC Practitioner - Diagnostic Radiology 9537533104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Icahn School of Medicine at Mount Sinai, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anne Arundel Urology, PAGroup PAC ID 9032178918, 33 clinicians

Practice addresses (Care Compare)

4201 Northview Dr
Suite 201
Bowie, MD 20716-2656
Phone (240) 544-4070

600 Ridgely Ave
Annapolis, MD 21401-1045
Phone (410) 266-8049

Merit-based Incentive Payment System (MIPS)

Final score
61.21 of 100Reported as group
Quality
80.09
Promoting interoperability
0
Improvement activities
40
Cost
73.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0096646MDMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Arundel Urology, PA CurrentSince Mar 27, 2023 Accepting new patients
Medical Center Radiologists Inc CurrentSince Nov 10, 2022 Accepting new patients
Anne Arundel Urology, PA CurrentSince Mar 30, 2023 Accepting new patients

Locations

600 Ridgely Ave
Ste 130
Annapolis, MD 21401
Phone 4102668049157

600 Ridgely Ave
Ste 120
Annapolis, MD 21401
Phone (410) 224-0070

4201 Northview Dr
Ste 201
Bowie, MD 20716
Phone (240) 544-4070

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

600 Gresham Dr
#700
Norfolk, VA 23507
Phone (757) 668-1370

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1023462975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E 14TH ST",
            "address_2": "APT 7C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100093210",
            "telephone_number": "443-602-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E 14TH ST",
            "address_2": "APT 7C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100093210",
            "telephone_number": "443-602-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODMER",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D0096646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.