Mark P Bodack, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

196328 Issued in NY

Practice address

1 Webster Ave
Atrium at SFH
Poughkeepsie, NY 12601-1361

Phone

(845) 483-5780

Fax

(845) 483-5787

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physical Medicine and Rehabilitation

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Westchester Medical Center Advanced Physician Services PCGroup PAC ID 3173660776, 879 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Westchester Medical Center Hospital, Valhalla, NY, CCN 330234
• Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
• Westchester Medical Center Inpatient rehabilitation facility, Valhalla, NY, CCN 33T234

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: mbodack@direct.health-quest.org
• Direct secure messaging: mark.bodack@wmchealth.cernerdirect.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

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.

• Westchester Medical Center Advanced Physician Services, PC

  • Surgery Physician
  • Valhalla, NY
  • NPI 1912131392

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Westchester Medical Center Advanced Physician Services PC

  • Anesthesiology Physician
  • Valhalla, NY
  • NPI 1740687458
  NPD
• Westchester Medical Center

  • General Acute Care Hospital
  • Valhalla, NY
  • NPI 1023286184
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Vassar Brothers Hospital

  • General Acute Care Hospital
  • Poughkeepsie, NY
  • NPI 1740233899
  Care Compare affiliation
• Vassar Brothers Medical Center

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1780052514

  Hospital

  Care Compare affiliation
• Westchester County Health Care Corporation

  • General Acute Care Hospital
  • Valhalla, NY
  • NPI 1932280666
  Care Compare affiliation
• Westchester County Health Care Corporation

  • Rehabilitation Hospital Unit
  • Valhalla, NY
  • NPI 1972778447

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1386635829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE",
            "address_2": "ATRIUM AT SFH",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011363",
            "telephone_number": "845-483-5780",
            "fax_number": "845-483-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE",
            "address_2": "ATRIUM AT SFH",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011361",
            "telephone_number": "845-483-5780",
            "fax_number": "845-483-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODACK",
        "first_name": "MARK",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "196328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01849729",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Bodack@wmchealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Webster Ave",
            "address_2": "Atrium at SFH",
            "city": "Poughkeepsie",
            "state": "NY",
            "country_code": "US",
            "postal_code": "126011361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blu-Hazel Therapy LLC
• Kizzy Blue, LPN
• Aaron Blum, MD
• Erika Bobinger
• Patrick Bobst, MS, LPC
• Praveen Kumar Boddu
• Rebecca Bogdanowicz, OTR/L
• Ashley Marie Bogdanski
• Rachel Bogert
• William E Bollengier, MD

• Physical Medicine & Rehabilitation Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.