David Bradley Bodkin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1461 Issued in SC

Practice address

1296 Long Grove Dr
Mount Pleasant, SC 29464-9462

Phone

(617) 970-2252

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

Yes

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.

• The Vision Center at Seaside Farms

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1710111588

  Optometrist, SC

  Medicare reassignment Care Compare group NPD Authorized official

Specialty

Optometry

Education

New England College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Vision Center at Seaside Farms 3 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 17, 2020.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1295875938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 LONG GROVE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649462",
            "telephone_number": "617-970-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 LONG GROVE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649462",
            "telephone_number": "617-970-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODKIN",
        "first_name": "DAVID",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14615",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlin Blum, LISW-CP,BCBA
• Sylvia Davis Blyth, R.D., L.D.
• Barbara S Boatwright, PHD
• Cynthia Boatwright, LPC
• David Allan Bodie, DMD
• Leah Boepple, PHD
• Ilah Boggs
• Laura Bogue
• Ellesse Boiwka, O.D.
• Lydia Maeve Boland

• All providers in Mount Pleasant, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.