Kenneth Alan Bodkin, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

YA000577 Issued in NJ

Practice address

30 Prospect Ave.
Dept. of Audiology
Hackensack, NJ 07601

Phone

(201) 996-5126

Fax

(201) 996-0557

NPI assigned

Feb 8, 2007

Last updated

Aug 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackensack Audiology and Hearing Aid Associates, LLCGroup PAC ID 7214094846, 4 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.

• Hackensack Audiology and Hearing Aid Associates, LLC

  • Audiologist
  • Hackensack, NJ
  • NPI 1194973818
  Medicare reassignment Care Compare group NPD Authorized official
• Hackensack Audiology and Hearing Aid Associates

  • Audiologist
  • Hackensack, NJ
  • NPI 1942755855
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1427199140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 808",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "201-996-5126",
            "fax_number": "201-996-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE.",
            "address_2": "DEPT. OF AUDIOLOGY",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-996-5126",
            "fax_number": "201-996-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODKIN",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "1552",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "YA000577",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG00090100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Serwaah Boakye-Danquah, RPH
• Marion Y Bobb-McKoy, MD
• Doreen J Bobby, M.S.W., L.C.S.W.
• Conrad A Bocksel, D.D.S.
• Abigail Victoria Bodeker, DMD
• Body Shop Physical Therapy and Wellness LLC
• Adam R Bogomol, M.D.
• Marie Bolona
• Jamie Lynn Boman, MSN
• Elizabeth Mary Bonarigo, DPM

• Audiologist in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Audiologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; 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.