Active NPI
Monique Bodine
- Peer Specialist
- Rochester, NY
National Provider Identifier
1871196493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- NYCPS-P-4884
- Practice address
- 1099 Jay St BLDG J
Rochester, NY 14611-1153 - Phone
- (585) 287-7110
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Peer Specialist | 175T00000X | NYCPS-P-4884 | NY | Primary |
Addresses
Primary practice location
1099 Jay St BLDG J
Rochester, NY 14611-1153
Mailing address
1099 Jay St BLDG J
Rochester, NY 14611-1153
Phone (585) 287-7110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NYCPS-P-4884 | NY | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Villa of Hope | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Voluntary or Charitable Agency
- Rochester, NY
- NPI 1578640298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659571200000",
"number": "1871196493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1099 JAY ST BLDG J",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146111153",
"telephone_number": "585-287-7110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1099 JAY ST BLDG J",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146111153",
"telephone_number": "585-287-7110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODINE",
"first_name": "MONIQUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NY",
"license": "NYCPS-P-4884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.