Peter A Bodi, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA003157L Issued in PA

Practice address

175 E Chester Pike
Ridley Park, PA 19078-2212

Phone

(610) 595-6586

Fax

(610) 595-6787

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cardiovascular Group LLC

  • Cardiovascular Disease Physician
  • Ridley Park, PA
  • NPI 1427050806
  NPD (past)
• Health Access Network

  • Physical Medicine & Rehabilitation Physician
  • Chester, PA
  • NPI 1356460380
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1891797205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782212",
            "telephone_number": "610-595-6586",
            "fax_number": "610-595-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782212",
            "telephone_number": "610-595-6586",
            "fax_number": "610-595-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODI",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": "C5-0000626",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003157L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Jane Benson
• Martin Jan Bergman, M.D.
• Rachel Bernard, PA-C
• Bestcare Nursing and Residential Services, Inc.
• Christine L. Blaine, PSY.D.
• Lee H Bogart, M.D.
• Ellen K Boyda, CRNP
• Melissa T Burkhart, MD
• Andreea Cadar, M.D.
• Latianna Cain-Bush, CRNP

• Medical Physician Assistant in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.