Kimberly Bodenlos

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

25MA10539800 Issued in NJ

Practice address

94 Old Short Hills Rd
East Wing, Suite 402
Livingston, NJ 07039-1962

Phone

(973) 322-5287

NPI assigned

Mar 31, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.bodenlos.1@32861.direct.athenahealth.com
• Direct secure messaging: kbodenlos19586@epicdirect.rwjbh.org

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.

• Bergen Perinatal Associates, LLC

  • Maternal & Fetal Medicine Physician
  • Teaneck, NJ
  • NPI 1053609867
  NPD (past)

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1265827869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "address_2": "EAST WING, SUITE 402",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391962",
            "telephone_number": "973-322-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENLOS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "NJ",
            "license": "25MA10539800",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA10539800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Donald Bloomstein, DDS
• Dana Joy Blumberg
• Kenneth Mark Blumberg, DDS
• Emmanuella Boakye
• Jessica F Bocchino, BSN, RN, RNFA
• Bodypro Physical Therapy, LLC
• Edward Joseph Boffa Jr., DC
• Jennifer Bonardi, M.S., CCC-SLP
• Diana Lynne Bonzulak Anweiler, COTA
• Shari Boockvar, RDN

• Maternal & Fetal Medicine Physician in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Maternal & Fetal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.