Ellen C Bodner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

NYS4201 Issued in NY

Practice address

20809 Union Tpke
Oakland Gardens, NY 11364-3235

Phone

(718) 479-6370

Fax

(718) 464-0954

NPI assigned

Jul 27, 2005

Last updated

Sep 23, 2011By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Ellen C. Bodner, PT, PC

  dba Ellen Bodner, PT,PC

  • Physical Therapist
  • Oakland Gardens, NY
  • NPI 1528277472
  Authorized official Same address or phone

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1285634725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20809 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643235",
            "telephone_number": "718-479-6370",
            "fax_number": "718-464-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20809 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643235",
            "telephone_number": "718-479-6370",
            "fax_number": "718-464-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNER",
        "first_name": "ELLEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-27",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "NYS4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Oakland Gardens, NY
• Providers in Oakland Gardens, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.