Ailiz Bodzo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111715 Issued in FL

Practice address

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905

Phone

(813) 615-7620

Fax

(813) 971-7953

NPI assigned

Dec 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alliz Nereyda Martin Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Baltimore Medical College, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

My Endocrinologist PAGroup PAC ID 8022290956, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• My Endocrinologist PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Winter Garden, FL
  • NPI 1497059737
  Medicare reassignment Care Compare group
• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Physician Assistant

  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  dba AdventHealth Orlando Outreach Laboratory

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Florida Hospital Waterman Inc

  dba AdventHealth Waterman

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation
• South Lake Hospital, Inc.

  dba Orlando Health South Lake Hospital

  • General Acute Care Hospital
  • Clermont, FL
  • NPI 1336221019
  Care Compare affiliation

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1609348044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133905",
            "telephone_number": "813-615-7620",
            "fax_number": "813-971-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13901 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133905",
            "telephone_number": "813-615-7620",
            "fax_number": "813-971-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODZO",
        "first_name": "AILIZ",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLIZ",
            "last_name": "MARTIN",
            "middle_name": "NEREYDA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Body Healing Therapy Center, Inc.
• Body Healthcare Center LLC
• Body Image Laser Institute
• Body Rehab LLC
• Body Total Health Care Center
• Eric Michael Boe, DMD
• Sydney Rae Boehnlein, MS, RD, LD, CSSD
• Jon P Boettger, P.A.
• Samantha Bogard, DO
• Caitlyn Mackenzie Bogart, OTR/L

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.