Karl D Bodendorfer, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME78478 Issued in FL

Practice address

1615 SW Main Blvd
Lake City, FL 32025-1108

Phone

(386) 755-2785

Fax

(386) 755-1128

NPI assigned

Aug 31, 2006

Last updated

Apr 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Karl David Bodendorfer Professional name

Medicare fee-for-service enrollment

Enrolled in FL2 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 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Columbia Eye Associates PA

  • Ophthalmology Physician
  • Lake City, FL
  • NPI 1295921096

  O20100930005696

  Same enrollment

Specialty

Ophthalmology

Education

Pennsylvania State University College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Eye Associates PAGroup PAC ID 7517950637, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/K8KD7A7C
• Direct secure messaging: kbodendorfer@ceapa.intellechartdirect.net

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.

• Columbia Eye Associates PA

  • Ophthalmology Physician
  • Lake City, FL
  • NPI 1295921096
  Medicare reassignment Care Compare group NPD Authorized official
• North Florida Surgery Center Inc

  dba North Florida Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Lake City, FL
  • NPI 1467582437
  NPD (past)
• Reichert Eye Centers of N FL, PA

  dba dba Family Focus Eye Care

  • Ophthalmology Physician
  • Lake City, FL
  • NPI 1902835069
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1205947959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320560489",
            "telephone_number": "386-755-2785",
            "fax_number": "386-755-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251108",
            "telephone_number": "386-755-2785",
            "fax_number": "386-755-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENDORFER",
        "first_name": "KARL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME78478",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME78478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259120100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259120101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00087109",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001933700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "35612A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARL",
            "last_name": "BODENDORFER",
            "middle_name": "DAVID",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nancy Thedis Blanton, LCSW
• Jennifer Blue
• Jean Blum, LMT
• Katie J Blunk, CTRS, CARSS II
• Charles Holloway Boardman IV, OTR
• Reka Bodo Holland, PHARMD
• Boh Health and Education LLC
• Derral Bomar
• Cayla Bonds
• Patricia Bonner

• Ophthalmology Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.
• 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.