Active NPI
Stanley S Bodzin, D.P.M.
- Podiatrist
- Cherry Hill, NJ
National Provider Identifier
1871607218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- MD103700
- Practice address
- 52 Berlin Rd
Suite 5000
Cherry Hill, NJ 08034-3574 - Phone
- (856) 795-1003
- Fax
- (856) 795-5994
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC001895L | PA | |
| Podiatrist | 213E00000X | MD103700 | NJ | Primary |
Addresses
Primary practice location
52 Berlin Rd
Suite 5000
Cherry Hill, NJ 08034-3574
Mailing address
52 Berlin Rd
Suite 5000
Cherry Hill, NJ 08034-3574
Phone (856) 795-1003
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6201283 | Other | GROUP HEALTH INSURANCE | |
| 0495000 | Medicaid | NJ | |
| 15222 | Other | UNIVERSITY HEALTH PLAN | |
| OXFORD | Other | P3065606 | |
| 066165 | Other | PA | IBC |
| 48674 | Other | PA | KEYSTONE MERCY HEALTH PLA |
| 0060537000 | Other | AMERIHEALTH | |
| 27-00990 | Other | EVERCARE | |
| SC001895L | Other | PA | HEALTH PARTNERS |
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 |
|---|---|---|---|
| MD103700 | NJ | MD | Podiatrist |
| SC001895L | PA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373846400000",
"number": "1871607218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 BERLIN RD",
"address_2": "SUITE 5000",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080343574",
"telephone_number": "856-795-1003",
"fax_number": "856-795-5994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 BERLIN RD",
"address_2": "SUITE 5000",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080343574",
"telephone_number": "856-795-1003",
"fax_number": "856-795-5994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODZIN",
"first_name": "STANLEY",
"middle_name": "S",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2013-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC001895L",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NJ",
"license": "MD103700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH INSURANCE",
"identifier": "6201283",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0495000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY HEALTH PLAN",
"identifier": "15222",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "P3065606",
"identifier": "OXFORD",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "066165",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY HEALTH PLA",
"identifier": "48674",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "0060537000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "27-00990",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "SC001895L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.