Kip Lord Bodi, MD FACS
Individual provider Active NPI Specialist · Greenlawn, NY
NPI 1982689428 · NPPES record last updated Apr 5, 2017
Key facts
- NPI
- 1982689428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 144782 (NY)
- Practice address
- 284 Pulaski Rd
2ND Floor
Greenlawn, NY 11740-1602 - Phone
- (631) 271-1608
- Fax
- (631) 271-1968
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Urology
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Shore-Lij Medical PC
Practice addresses (Care Compare)
1111 Marcus Ave
New Hyde Park, NY 11042-1034
270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2356
284 Pulaski Rd
Suite 2
Greenlawn, NY 11740-1602
Phone (631) 670-3456
300 Community Dr
Manhasset, NY 11030-3816
300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229
330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550
350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845
Hospital & facility affiliations
- North Shore University Hospital
- NS/Lij HS Huntington Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.07 of 100
- Quality
- 79.77
- Promoting interoperability
- 88.77
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040415001190 | NY | Practitioner - Urology | 4082609482 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Current |
Accepting new patients |
Locations
284 Pulaski Rd
#2
Greenlawn, NY 11740
Phone (631) 271-1608
180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121
300 Community Dr
Plandome, NY 11030
14 Technology Dr
Setauket, NY 11733
Phone (516) 444-1357
972 Brush Hollow Rd
Westbury, NY 11590
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Interoperability endpoints
- kipbodi@nslijmedgr.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 144782 | NY | Yes |
Addresses
Primary practice location
284 Pulaski Rd
2ND Floor
Greenlawn, NY 11740-1602
Mailing address
284 Pulaski Rd
2ND Floor
Greenlawn, NY 11740-1602
Phone (631) 271-1608
Other providers in Greenlawn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.