DR. WAYNE JOSEPH BODAMER (NPI# 1457317562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457317562 |
Entity Type | Individual |
Full Name | DR. WAYNE JOSEPH BODAMER |
Credential | D.P.M. |
Practice Address |
373 Route 111 Smithtown NY 11787-4759 |
Mailing Address |
1641 Route 112 Medford NY 11763-3635 |
Practice Telephone | 6312658802 |
Practice Fax Number | 6312658809 |
Mailing Telephone | 6314470800 |
Mailing Fax Number | 6314470801 |
Enumeration Date | 2006-04-26 |
Last Update Date | 2007-11-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
003889 | NY | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | OXFORD HEALTH PLAN | P368761 | 01 |
NY | GHI | 0056853 | 01 |
NY | CIGNA HMO | 0301399-007 | 01 |
NY | AETNA US HEALTHCARE | 96401 | 01 |
NY | EMPIRE BLUECROSS/BLUE SHI | P41901 | 01 |
NY | HEALTHNET | PPD162 | 01 |
NY | MDNY | AH00139 | 01 |
Street Address |
373 ROUTE 111 |
City | SMITHTOWN |
State | NY |
Zip Code | 11787-4759 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881686418 | Morton B Weinberg | Dermatology | 373 Route 111, Suite 10, Smithtown, NY 11787-4759 | 2005-08-19 |
1073993218 | Mitchell N Shapiro Dds PC | Dentist | 373 Route 111, Ste 16, Smithtown, NY 11787-4759 | 2015-06-03 |
1215245220 | Andreas Costas Michaelides | Psychologist | 373 Route 111, Suite 10, Smithtown, NY 11787-4759 | 2010-09-24 |
1609103522 | Morton B Weinberg Md PC | Dermatology | 373 Route 111, Suite 10, Smithtown, NY 11787-4759 | 2009-11-13 |
1790907566 | Mitchell Neil Shapiro | Dentist | 373 Route 111, Suite 16, Smithtown, NY 11787-4759 | 2007-05-02 |
1881758225 | Total Foot Care,pc | Podiatrist | 373 Route 111, Smithtown, NY 11787-4759 | 2006-12-20 |
1790846244 | Mark Julian Zuckerman | Psychiatry & Neurology | 373 Route 111, Suite 20, Smithtown, NY 11787-4759 | 2006-12-12 |
1235201328 | Elite Medical,pc | Internal Medicine | 373 Route 111, Suite 14, Smithtown, NY 11787-4759 | 2006-11-14 |
1093803785 | Howard S Lynn | Urology | 373 Route 111, Suite 7, Smithtown, NY 11787-4759 | 2006-10-10 |
1215038666 | Amy Shapiro | Dietitian, Registered | 373 Route 111, Suite 16, Smithtown, NY 11787-4759 | 2006-09-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
Find all providers in zip 11787 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801237425 | Anthony Vincent Zizzamia | Podiatrist | 260 E Middle Country Rd, Suite 104, Smithtown, NY 11787-2982 | 2013-07-11 |
1881758225 | Total Foot Care,pc | Podiatrist | 373 Route 111, Smithtown, NY 11787-4759 | 2006-12-20 |
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1518566108 | Vu Nguyen Corp | Podiatrist | 8622 Bay Pkwy Ste 2b, Brooklyn, NY 11214-4170 | 2020-10-23 |
1255930079 | Atlantic Podiatry Pllc | Podiatrist | 489 Atlantic Ave # 1a, Brooklyn, NY 11217-2985 | 2020-10-22 |
1891393906 | Finger Lakes Podiatry of Geneva, Pllc | Podiatrist | 220 Phoenix Mills Plz, Victor, NY 14564-1414 | 2020-10-12 |
1497378699 | Zh Podiatrist of Westchester PC | Podiatrist | 150 Edgepark Rd, White Plains, NY 10603-2106 | 2020-05-21 |
1528696259 | Capital District Podiatry, Pllc | Podiatrist | 855 Route 146 Bldg B, Clifton Park, NY 12065-3885 | 2020-03-30 |
1629615588 | Kelly Lucas Dpm PC | Podiatrist | 925 Hempstead Tpke Ste 110, Franklin Square, NY 11010-3636 | 2019-12-10 |
1811544257 | Christopher Chow Dpm PC | Podiatrist | 749 61st St Ste 503, Brooklyn, NY 11220-4211 | 2019-08-21 |
1063074565 | Balance Foot and Ankle LLC | Podiatrist | 611 Mitchel Field Way, Garden City, NY 11530-5057 | 2019-07-03 |
1083270979 | Jones Thomas | Podiatrist | 518 Terrace Blvd, New Hyde Park, NY 11040-4343 | 2019-05-15 |
1316419690 | Rockaway Podiatry Pllc | Podiatrist | 1957 Flatbush Ave, Brooklyn, NY 11234-2819 | 2018-12-26 |
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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.