Individual provider Active NPI

Yaroslav Daniel Bodnar, MD

  • Pediatrics Physician
  • Hillsborough, NC
National Provider Identifier
1801326095
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2024-01939 Issued in NC
Practice address
210 S Cameron St
Hillsborough, NC 27278-2505
Phone
(919) 732-9311
NPI assigned
Jun 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2024-01939 NC
Pediatrics Physician 208000000X 125.070456 IL
Pediatrics Physician 208000000X 036155975 IL
Pediatrics Physician 208000000X 2024-01939 NC Primary
Internal Medicine Physician 207R00000X 125.070456 IL

Addresses

Primary practice location

210 S Cameron St
Hillsborough, NC 27278-2505

Mailing address

5221 Paramount Pkwy Ste 220
Morrisville, NC 27560-5490
Phone (984) 215-4111

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-3863

Other identifiers 1

IdentifierTypeStateIssuer
125.070456OtherILTEMPORARY MEDICAL LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ybodnar147037@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER
Direct Messaging Address ybodnar1184352@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240815000224 NC Practitioner - Pediatric MedicinePractitioner - Internal Medicine 0143587113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

210 S Cameron St
Hillsborough, NC 27278-2505
Phone (919) 732-9311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.070456ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Internal Medicine CurrentSince Aug 5, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Unc Physicians Network LLC Current Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

210 S Cameron St
Hillsborough, NC 27278
Phone (919) 732-9311

919 S Fifth St
Mebane, NC 27302
Phone (919) 563-2896

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

Interoperability endpoints

  • Direct secure messaging: ybodnar1184352@direct.unc.nchie.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1801326095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490",
            "telephone_number": "984-215-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S CAMERON ST",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272782505",
            "telephone_number": "919-732-9311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-3863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "YAROSLAV",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2024-01939",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.070456",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036155975",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2024-01939",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.070456",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY MEDICAL LICENSE",
            "identifier": "125.070456",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ybodnar147037@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ybodnar1184352@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "210 S Cameron St",
            "city": "Hillsborough",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272782505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hillsborough, NC

Sources for this page

Verify at the official NPI Registry.