Samantha Kasi Bodiford, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A165398 Issued in CA

Practice address

949 Palm Ave
Imperial Beach, CA 91932-1503

Phone

(619) 429-3733

NPI assigned

Mar 27, 2018

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBEEDD
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10012052
• Direct secure messaging: sbodiford77547@scrippshlth.medalliesdirect.net
• Direct secure messaging: samanthabodiford@ibcc.allscriptsdirect.net
• Direct secure messaging: samantha.bodiford.1@21049.direct.athenahealth.com

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.

• Imperial Beach Community Clinic

  • Community Health Clinic/Center
  • Imperial Beach, CA
  • NPI 1790718351
  Medicare reassignment NPD
• Imperial Beach Community Clinic

  • Community Health Clinic/Center
  • San Diego, CA
  • NPI 1215246996
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1730684200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 E 15TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919504707",
            "telephone_number": "760-681-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 PALM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321503",
            "telephone_number": "619-429-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODIFORD",
        "first_name": "SAMANTHA",
        "middle_name": "KASI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A165398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund Jose Bajet, LPCC
• Laura Becker
• Curtis Benedetto, AOD
• Carlyn Angela Blevins, MS, RD
• Gwenda Lynn Blum
• Magdalena Bojarczak
• Sarah Elizabeth Bradley, MSW, LCSW
• Angela Marie Brignole
• Daisy Bueno, RN, BSN
• Ca Reliable Medical Syst Inc

• Family Medicine Physician in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.