NPIMap

Individual provider Active NPI

David J Bodosky, DO

  • Family Medicine Physician
  • Albion, PA
National Provider Identifier
1568427201
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS011001L Issued in PA
Practice address
210 E State St
Albion, PA 16401-1306
Phone
(814) 756-3434
Fax
(814) 756-4725
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS011001L PA Primary

Addresses

Primary practice location

210 E State St
Albion, PA 16401-1306

Mailing address

1 Lecom PL
Erie, PA 16505-2571

Other identifiers 1

IdentifierTypeStateIssuer
0018921900003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051208000200 PA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 7719908516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of ErieGroup PAC ID 2769402783, 25 clinicians
Millcreek Community HospitalGroup PAC ID 8426020173, 67 clinicians
Mrs Physical TherapyGroup PAC ID 0042128407, 168 clinicians

Practice addresses (Care Compare)

210 E State St
Albion, PA 16401-1306
Phone (814) 756-3434

4538 Peach St
Erie, PA 16509-1364
Phone (814) 864-6650

Hospital & facility affiliations

  • Vna Alliance Home health agency, Meadville, PA, CCN 397655
  • Allegheny Health Network Healthcare at Home Home H Home health agency, Warrendale, PA, CCN 398069
  • Lecom Medical Center and Behavioral Health Pav Hospital, Erie, PA, CCN 390198
  • Upmc Hamot Hospital, Erie, PA, CCN 390063
  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS011001LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital Family Medicine Current Accepting new patients
Medical Associates of Erie Family Medicine CurrentSince Nov 1, 2005 Accepting new patients
Medical Associates of Erie Family Medicine Current Accepting new patients
Millcreek Community Hospital Family Medicine CurrentSince Jun 30, 2024 Accepting new patients
Millcreek Community Hospital CurrentSince Jun 30, 2024 Accepting new patients
Medical Associates of Erie Family Medicine CurrentSince Nov 1, 2005 Accepting new patients
Millcreek Community Hospital Current Accepting new patients

Locations

210 E State St
Albion, PA 16401
Phone (814) 756-3434

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

1 Lecom Pl
Erie, PA 16505

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

Interoperability endpoints

  • Direct secure messaging: dbodosky@maoeim-pa.direct.office.nextgen.com

Organizations & group practices 8

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1568427201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E STATE ST",
            "city": "ALBION",
            "state": "PA",
            "postal_code": "164011306",
            "telephone_number": "814-756-3434",
            "fax_number": "814-756-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODOSKY",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS011001L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018921900003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albion, PA

Sources for this page

Verify at the official NPI Registry.