Stanley Bodner, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6557-1 Issued in NY

Practice address

1579 E 29TH St
Brooklyn, NY 11229-1846

Phone

(718) 339-4916

Fax

(718) 339-5997

NPI assigned

Sep 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Columbia University College of Physicians and Surgeons, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1851385546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291846",
            "telephone_number": "718-339-4916",
            "fax_number": "718-339-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 E 29TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291846",
            "telephone_number": "718-339-4916",
            "fax_number": "718-339-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNER",
        "first_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "6557-1",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "6557-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "6557-1",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "6557-1",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "6557-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Bodner
• Eva Bodner
• Fagie Bodner, O.T.
• Ita Bodner
• Leah Bodner
• Yael Bodner
• Amy Bodnick
• Sairou M Bodounr
• Body
• Body Alliance Physical Therapy,PC

• Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.