Stephanie M. Bodor, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

212971 Issued in MA

Practice address

77 W. Main St.
Hopkinton, MA 01748

Phone

(508) 435-5506

Fax

(508) 497-5079

NPI assigned

Jul 10, 2006

Sex

Female

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 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: sbodor7907@direct.chppoc.masshiway.net

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1467486118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W. MAIN ST.",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "01748",
            "telephone_number": "508-435-5506",
            "fax_number": "508-497-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W. MAIN ST.",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "01748",
            "telephone_number": "508-435-5506",
            "fax_number": "508-497-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODOR",
        "first_name": "STEPHANIE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "212971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "J24759",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "2942274",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2942274",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "204597",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "461234",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192970",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE(CMHC)",
            "identifier": "198177",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6079812001",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Lynn Bertuglia, PH.D.
• Birchwood Nutrition Group Inc.
• Dylan Hewins Blackwell, PTA
• Emily Katherine Blake
• Jill Marie Blethen, PT
• Body N' Beyond, Inc.
• Danielle R Bond, DDS
• Christine Michelle Bonneau, PMHNP
• Corey Brunner, D.C.
• Melinda Bryant, DMD

• Pediatrics Physician in Hopkinton, MA
• Providers in Hopkinton, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.