Individual provider Active NPI

Mashhood Ahmad Bodla, MBBS

  • Internal Medicine Physician
  • Ithaca, NY
National Provider Identifier
1669092805
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
324393 Issued in NY
Practice address
905 Hanshaw Road, Suite C
Ithaca, NY 14850
Phone
(607) 277-2170
NPI assigned
Apr 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 324393 NY Primary

Addresses

Primary practice location

905 Hanshaw Road, Suite C
Ithaca, NY 14850

Mailing address

Cayuga Medical Associates
1301 Trumansburg Road, Suite P
Ithaca, NY 14850
Phone (607) 252-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230822001476 NY Practitioner - Internal Medicine 8921460098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

905 Hanshaw Rd
Suite C
Ithaca, NY 14850-1549
Phone (607) 277-2170

Hospital & facility affiliations

  • VNS Ithaca Tompkins Co Chha Home health agency, Ithaca, NY, CCN 337212
  • Hospicare & Palliative Care Services Hospice, Ithaca, NY, CCN 331512
  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
324393NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Associates, PC Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients
Cayuga Medical Associates, Inc. PastSince Sep 5, 2023 Accepting new patients

Locations

905 Hanshaw Rd
#C
Ithaca, NY 14850
Phone (607) 277-2170

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100

Interoperability endpoints

  • Direct secure messaging: mbodla27165@direct.xtensys.com

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1669092805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAYUGA MEDICAL ASSOCIATES",
            "address_2": "1301 TRUMANSBURG ROAD, SUITE P",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-252-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 HANSHAW ROAD, SUITE C",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-277-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODLA",
        "first_name": "MASHHOOD",
        "middle_name": "AHMAD",
        "name_prefix": "Mr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-17",
        "last_updated": "2023-08-22",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "324393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.