Stephanie Marie Bodnar, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86051787 Issued in PA

Practice address

1991 Sproul Rd
Broomall, PA 19008-3512

Phone

(610) 202-3476

NPI assigned

Apr 11, 2018

Last updated

Jan 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1174020523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BARBARA DR",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643602",
            "telephone_number": "610-202-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "610-202-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "86051787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Benziger, CRNA
• Brianna Bernardo, PSYD
• Twinkle S Bhalodia, CRNP
• Seth M. Blitzer, DMD
• Blossom Home Care LLC
• Jeffrey Bomze, MD
• Andrew G Bongiovanni, DO
• Jessica Bordas, BT
• Andrew Jeffrey Borson, PH.D.
• Linda Simone Borson, M.ED.

• Registered Dietitian in Broomall, PA
• Providers in Broomall, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.