NPIMap

Individual provider Active NPI

Vimal M Bodiwala, MD

  • Gastroenterology Physician
  • Wilkes Barre, PA
National Provider Identifier
1750813556
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD61412880 Issued in WA
Practice address
675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone
(570) 808-5780
Fax
(570) 808-5753
NPI assigned
Mar 30, 2017
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD61412880 WA Primary

Addresses

Primary practice location

675 Baltimore Dr
Wilkes Barre, PA 18702-7900

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 414-2730

Other practice location 2

1 Rwj Pl
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113004591 PA Practitioner - Gastroenterology 7113384793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone (570) 826-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.15 of 100Reported as apm
Quality
83.54
Promoting interoperability
94.52
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.2 of 100Reported as group
Quality
84.35
Promoting interoperability
100
Improvement activities
40
Cost
79.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy146
Upper gastrointestinal (GI) endoscopy for acid reflux105

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Nov 1, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2024 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

Interoperability endpoints

  • Direct secure messaging: vbodiwala616433@direct.geisinger.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1750813556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 BALTIMORE DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027900",
            "telephone_number": "570-808-5780",
            "fax_number": "570-808-5753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Delaware St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322367",
            "country_code": "US",
            "telephone_number": "360-414-2730",
            "fax_number": "360-414-2739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Rwj Pl",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011928",
            "country_code": "US",
            "telephone_number": "732-828-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODIWALA",
        "first_name": "VIMAL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD61412880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.