Brianna Boderman, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

8124120 Issued in WI

Practice address

600 Highland Ave
Madison, WI 53792-0001

Phone

(218) 343-4462

NPI assigned

Apr 1, 2021

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brianna Lally Former name

Medicare fee-for-service enrollment

Enrolled in WI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1043898687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UW HOSPITALS AND CLINICS 600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537922401",
            "telephone_number": "608-263-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "218-343-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODERMAN",
        "first_name": "BRIANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "8124120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "LALLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rohan Chandra Kashyap Bodapati Venkata Naga, MD
• Jillian Marie Bodden Hoenisch, DNP, AGPCNP-BC, APNP
• Sarah Genheimer Bodden, PA-C
• Apple A Bodemer, MD
• Lisa Bodenhamer
• Samuel Boderman
• Haley Marie Bodette, MD
• Laura M Bodine, RDN
• Catherine Bodnar
• Natalie Bodnar, MD

• Student in an Organized Health Care Education/Training Program in Madison, WI
• Providers in Madison, WI by specialty
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.