Individual provider Active NPI

Timothy William Bodnar, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Ann Arbor, MI
National Provider Identifier
1275796989
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301092124 Issued in MI
Practice address
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone
(734) 647-5871
NPI assigned
Jul 3, 2008
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301092124 MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301092124 MI Primary

Addresses

Primary practice location

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

5333 McAuley Dr
Reichert Health Building, Suite 5115
Ypsilanti, MI 48197-1014
Phone (734) 434-4430

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.bodnar@stjoeshealth.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20140610002132 MI Practitioner - Internal MedicinePractitioner - Endocrinology 8224277462 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
Ann Arbor Endocrinology and Diabetes Associates, P.C. Endocrinology, Diabetes & Metabolism CurrentSince Jul 21, 2014 Accepting new patients
Iha Health Service Corporation CurrentSince Jan 1, 2015 Accepting new patients
Regents of the University of Michigan CurrentSince Nov 23, 2021 Accepting new patients
Regents of the University of Michigan Internal Medicine CurrentSince Nov 23, 2021 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5333 McAuley Dr
Rm 4001
Ypsilanti, MI 48197
Phone (734) 712-3376

5333 McAuley Dr
Rm 5115
Ypsilanti, MI 48197
Phone (734) 434-4430

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAFIBA
  • Direct secure messaging: tbodnar25241@direct.trinity-health.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1275796989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-647-5871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5333 McAuley Dr",
            "address_2": "Reichert Health Building, Suite 5115",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971014",
            "country_code": "US",
            "telephone_number": "734-434-4430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "TIMOTHY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092124",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301092124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.bodnar@stjoeshealth.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5333 McAuley Dr",
            "address_2": "Reichert Health Building, Suite 5115",
            "city": "Ypsilanti",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481971014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.