ALEX B BODENSTAB (NPI# 1104806025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104806025 |
Entity Type | Individual |
Full Name | ALEX B BODENSTAB |
Credential | MD |
Practice Address |
4745 Ogletown Stanton Rd Suite 225 Newark DE 19713-2067 |
Mailing Address |
211 Executive Dr Ste 11 Newark DE 19702-3358 |
Practice Telephone | 3027312888 |
Practice Fax Number | 3027317049 |
Mailing Telephone | 3027312888 |
Mailing Fax Number | 3027317049 |
Enumeration Date | 2006-01-18 |
Last Update Date | 2018-10-05 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgery | CI0002138 | DE | Allopathic & Osteopathic Physicians |
Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
CI0002138 | DE | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DE | 000182801 | 05 |
Street Address |
4745 OGLETOWN STANTON RD SUITE 225 |
City | NEWARK |
State | DE |
Zip Code | 19713-2067 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831194224 | Mehdi Balakhani | Specialist | 4745 Ogletown Stanton Rd, Map #1, Suite 226, Newark, DE 19713-2067 | 2005-06-14 |
1912439829 | Dirm Surgery Center | Clinic/Center | 4745 Ogletown Stanton Rd, Suite 117, Newark, DE 19713-2067 | 2017-03-30 |
1821548025 | Danielle M Corsi | Registered Nurse | 4745 Ogletown Stanton Rd, Map 1, Suite 217, Newark, DE 19713-2067 | 2016-10-12 |
1386194116 | Sooin Lee | Nurse Practitioner | 4745 Ogletown Stanton Rd, Map 1, Suite 217, Newark, DE 19713-2067 | 2016-10-05 |
1023564499 | Hosmane Eye Care LLC | Optometrist | 4745 Ogletown Stanton Rd, Pavillion 1, Suite 135, Newark, DE 19713-2067 | 2016-08-26 |
1407202807 | Lisa Wei Schmidt | Physician Assistant | 4745 Ogletown Stanton Rd, Ste 225, Newark, DE 19713-2067 | 2016-05-04 |
1619341328 | Keri Ann E. Flanagan | Registered Nurse | 4745 Ogletown Stanton Rd, Map 1, Suite 217, Newark, DE 19713-2067 | 2015-11-18 |
1124496807 | Kaysha P Michel | Registered Nurse | 4745 Ogletown Stanton Rd, Suite 220, Newark, DE 19713-2067 | 2015-09-11 |
1376922799 | Chanhsamone Syravanh | Physician Assistant | 4745 Ogletown Stanton Rd, Medical Arts Pavilion 1, Suite 135, Hosmane Cardiology, Newark, DE 19713-2067 | 2015-05-19 |
1548652704 | Kristin M Fawcett | Nurse Practitioner | 4745 Ogletown Stanton Rd, Suite 217, Newark, DE 19713-2067 | 2015-02-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518574490 | Stacie Guyton | Nurse Practitioner | 4501 Ogletown Stanton Road, Newark, DE 19713 | 2020-09-25 |
1225674633 | Michael Francis Stant | Specialist/Technologist | Delaware Field House, 617 South College Avenue Rm 111b, Newark, DE 19713 | 2019-11-20 |
1528559457 | Sarah Mun | Physician Assistant | 4755 Ogletown Stanton Rd, Newark, DE 19713 | 2018-05-26 |
1568983286 | Clarice Wanisku Kariuki | Licensed Practical Nurse | 15 Prestbury Square, Suite 14, Nweark, DE 19713 | 2017-07-03 |
1679029870 | Auxilia Akala | Nurse Practitioner | 1082 Churchmans Rd, Newrk, DE 19713 | 2016-08-28 |
1003369851 | Yawar Abbas | Psychiatry & Neurology | Rockford Center, 100 Rockford Dr, Newark, DE 19713 | 2016-07-28 |
1700245925 | Debra Hutz | Counselor | 25 Omega Dr., Professional Center #j, Newark, DE 19713 | 2016-02-16 |
1376918201 | Aquiles Igleisias | Speech-Language Pathologist | 540 South College Avenue, Newark, DE 19713 | 2015-12-03 |
1639547359 | Kylee Rose | Social Worker | 901 S. Chapel Street, Newark, DE 19713 | 2015-09-11 |
1932503976 | Kathleen Madara | Physical Therapist | 540 S College Ave, Suite 210, University of Delaware, Newark, DE 19713 | 2014-10-20 |
Find all providers in zip 19713 |
Taxonomy Code | 207XS0114X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Adult Reconstructive Orthopaedic Surgery |
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164786687 | Craig Smucker, Md Orthopaedics, PC | Orthopaedic Surgery | 2600 Glasgow Ave, Suite 106, Newark, DE 19702-4773 | 2012-06-29 |
1528142197 | Calin S. Moucha | Orthopaedic Surgery | 30 Bergen St, Admc 12 1205, Newark, NJ 07107-3000 | 2006-10-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649535147 | Craig Smucker Md Orthopaedics PC | Orthopaedic Surgery | 1100 S Broom St, Wilmington, DE 19805-4585 | 2012-07-10 |
1568404424 | David Axon | Orthopaedic Surgery | 4512 Kirkwood Hwy, Suite 202, Wilmington, DE 19808-5123 | 2006-06-12 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.