Individual provider Active NPI

Donald R Bodner, MD

  • Urology Physician
  • Cleveland, OH
National Provider Identifier
1578597175
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35-044291 Issued in OH
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 844-5661
Fax
(216) 286-6341
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35-044291 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714

Other identifiers 10

IdentifierTypeStateIssuer
000000025982OtherOHANTHEM
000000216802OtherOHUNISON
639506OtherOHAETNA
000000507513OtherOHANTHEM
0441963MedicaidOH
363367OtherOHWELLCARE
P00364270OtherOHRAILROAD MEDICARE
0639506OtherOHAETNA
1900369OtherOHUHC
741846OtherOHBUCKEYE

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address donaldbodner@uhps.allscriptsdirect.net
Direct Messaging Address donaldbodner@uhps.allscriptsdirect.net
Direct Messaging Address donaldbodner@uhps.allscriptsdirect.net
Direct Messaging Address donaldbodner@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20041217000721 OH Practitioner - Urology 2365409612 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-044291OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Jan 1, 2007 Accepting new patients
University Family Medicine Association Past Accepting new patients

Locations

25501 Chagrin Blvd
Beachwood, OH 44122
Phone (216) 545-4800

88 Warrensville Center Rd
Bedford Heights, OH 44146
Phone (216) 587-3422

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

10701 East Blvd
Cleveland, OH 44106
Phone (216) 791-2300

11100 Euclid Ave
Cleveland Heights, OH 44106

24701 Euclid Ave
Fl 3
Euclid, OH 44117
Phone (216) 383-6950

29001 Cedar Rd
Ste 202
Lyndhurst, OH 44124
Phone (440) 461-7999

5850 Landerbrook Dr
Mayfield Hts, OH 44124
Phone (216) 844-3936

1611 S Green Rd
South Euclid, OH 44121
Phone (216) 286-6295

Interoperability endpoints

  • Direct secure messaging: dbodner36251@ehrdirect.uhhospitals.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1578597175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "3RD FLOOR",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-5661",
            "fax_number": "216-286-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNER",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35-044291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000025982",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000216802",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "639506",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000507513",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0441963",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "363367",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00364270",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0639506",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1900369",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "741846",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donaldbodner@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "11100 Euclid Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donaldbodner@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "29001 Cedar Rd Ste 202",
            "city": "Lyndhurst",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441244041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donaldbodner@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "10701 East Blvd",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donaldbodner@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "25501 Chagrin Blvd",
            "city": "Beachwood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441225603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.