Theresa Bodine, PA
Individual provider Active NPI Physician Assistant · Geneva, NY
NPI 1780746487 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1780746487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 004448-1 (NY)
- Practice address
- 200 North St
Geneva, NY 14456-1561 - Phone
- (315) 787-5100
- Fax
- (315) 787-5108
- NPI assigned
- Dec 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arnot Medical Services PLLC
Arnot Ogden Medical Center
Practice addresses (Care Compare)
100 John Roemmelt Dr
Horseheads, NY 14845-8303
571 Saint Josephs Blvd
Suite 304
Elmira, NY 14901-3234
Phone (607) 737-7012
600 Fitch St
Elmira, NY 14905-1634
600 Roe Ave
Elmira, NY 14905-1629
Hospital & facility affiliations
- Arnot Ogden Medical Center
- Cayuga Medical Center at Ithaca
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.64 of 100
- Quality
- 55.31
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 76.8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050425000333 | NY | Practitioner - Physician Assistant | 1658319173 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004448 | NY | MD | Behavioral Analyst |
| 004448-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arnot Ogden Medical Center | Current |
Accepting new patients | |
| Arnot Ogden Medical Center | Current |
Accepting new patients | |
| Ira Davenport Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Ira Davenport Memorial Hospital, Inc. | Current |
Accepting new patients |
Locations
7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500
600 Fitch St
Ste 102
Elmira, NY 14905
Phone (607) 734-6544
600 Ivy St
Ste 206
Elmira, NY 14905
Phone (607) 271-2050
600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161
600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639
100 John Roemmelt Dr
Ste 202
Horseheads, NY 14845
Phone (607) 795-2820
Interoperability endpoints
- theresa.bodine@arn.eclinicaldirectplus.com
- tbodine235144@direct.rochesterregional.org
- tbodine20196@direct.xtensys.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004448-1 | NY | Yes |
Addresses
Primary practice location
200 North St
Geneva, NY 14456-1561
Mailing address
571 Saint Josephs Blvd
FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1793526 | Medicaid | NY | |
| P0190044448 | Other | NY | BLUE CROSS |
| 105524CK | Other | NY | PREFERRED CARE |
| P00003448 | Other | NY | R.R. MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tbodine235144@direct.rochesterregional.org | Direct |
Other providers in Geneva, NY
- Daniel Elias Berns
- Patrick Billups
- Paul L Bleakley
- Brianna Christine Bliek
- Ruth Anne Blowers
- Bethanne D Bond
- Christina Brennan
- Karen S Brennan
- Thomas K Brennan
- Brian C. Solomon
All providers in Geneva, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.