Individual provider Active NPI

Stephen Douglas Bode, PT

  • Physical Therapist
  • Pittsburgh, PA
National Provider Identifier
1285753152
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014074L Issued in PA
Practice address
100 S Jackson Ave
Pittsburgh, PA 15202-3428
Phone
(412) 734-6030
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT014074L PA Primary

Addresses

Primary practice location

100 S Jackson Ave
Pittsburgh, PA 15202-3428

Mailing address

100 S Jackson Ave
Pittsburgh, PA 15202-3428
Phone (412) 734-6030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120001834 PA Practitioner - Physical Therapist in Private Practice 0941614648 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT014074LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Oct 16, 2020 Accepting new patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Oct 16, 2020 Accepting new patients

Locations

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

100 S Jackson Ave
Pittsburgh, PA 15202
Phone (412) 734-6030

4 Allegheny Ctr
Fl 7
Pittsburgh, PA 15212

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1285753152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S JACKSON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152023428",
            "telephone_number": "412-734-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JACKSON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152023428",
            "telephone_number": "412-734-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODE",
        "first_name": "STEPHEN",
        "middle_name": "DOUGLAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT014074L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.