Sara Michelle Bodack, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

LD60953985 Issued in WA

Practice address

2525 NE 139TH St Ste 230
Vancouver, WA 98686-2719

Phone

(360) 882-2778

Fax

(360) 604-1673

NPI assigned

Aug 10, 2009

Last updated

Sep 30, 2019By the provider in NPPES

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

Enrolled in WA

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Vancouver Clinic Inc PS

  dba The Vancouver Clinic

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment Care Compare group NPD
• The Vancouver Clinic Inc PS

  dba Salmon Creek 2 Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Pharmacy

  • Pharmacist
  • Vancouver, WA
  • NPI 1336365857
  NPD (past)

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1356573356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST STE 230",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODACK",
        "first_name": "SARA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80250",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD60953985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobo Primary Care LLC
• Bobo Primary Care LLC
• Bona Bobo, APRN
• Andrea Kay Bochart, PTA
• Christina Boda, RDN
• Karen Bode, LMP
• Amanda Boden
• Bernadette Bodle, LMP
• Bogdan Nikolayevich Bodroug, D.D.S.
• Body in Balance Chiropractic and Wellness Center

• Audiologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Audiologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.