Tania Patricia Nisimblat Bodnar, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

10757475-1205 Issued in UT

Practice address

900 Round Valley Dr Ste 200
Park City, UT 84060-7552

Phone

(435) 658-7400

NPI assigned

Feb 6, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

• Direct secure messaging: tania.nisimblat-bodna.1@14863.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154

  UT

  Medicare reassignment NPD
• Ogden Clinic Specialty Services LLC

  • Sports Medicine (Family Medicine) Physician
  • Ogden, UT
  • NPI 1114203668

  UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  • Neonatal-Perinatal Medicine Physician
  • Ogden, UT
  • NPI 1992027445
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ogden Clinic PC

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1578550083

  Obstetrics & Gynecology

  NPD

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1750520201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR STE 200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "435-658-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIMBLAT BODNAR",
        "first_name": "TANIA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-06",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "056880546",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "10757475-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Chapters Therapy
• Viet Nguyen, M.D.
• Sara Nibley
• Andrew Nichols, PH.D.
• Jared R. Nielsen, D.C.
• Bailey Jean Nissen
• Jennifer L Nissenbaum
• Melvin Norton, PTA
• Kirsten Leah Novak, M.D.
• Nadine Nye, M.S., CCC-SLP

• All providers in Park City, UT
• Obstetrics & Gynecology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.