Peter R Bodnar, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25515 Issued in AZ

Practice address

6544 E Carondelet Dr
Tucson, AZ 85710-2117

Phone

(520) 333-7723

Fax

(520) 333-3113

NPI assigned

Jan 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1083762389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6544 E CARONDELET DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102117",
            "telephone_number": "520-333-7723",
            "fax_number": "520-333-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6544 E CARONDELET DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102117",
            "telephone_number": "520-333-7723",
            "fax_number": "520-333-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "PETER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "25515",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AZ",
            "license": "25515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Bodan
• Barbara Young Bode, MD
• Edward B Bodin, DMD
• Sarah Nicole Bodine, MD
• Jennifer Lynn Bodley, O.D.
• Phillip Bodner, CRNA
• Kathy Bodwell, LCSW
• Bodycentral Physical Therapy P C
• Bodycentral Physical Therapy PC
• Bodyworx Center LLC

• Neurology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Neurology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.