Bodhi & Sage, Llc is a medicare enrolled "Clinic/center - Physical Therapy" provider in Chicago, Illinois. Their current practice location is
1525 E 53rd St Ste 808, Chicago, Illinois. You can reach out to their office (for appointments etc.) via phone at
(312) 403-1853.
Bodhi & Sage, Llc is licensed to practice in Illinois (license number 070013559) and it also participates in the medicare program. Bodhi & Sage, Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1538534359.
Healthcare Provider's Profile
| Full Name | Bodhi & Sage, Llc |
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| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 1525 E 53rd St Ste 808, Chicago, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538534359
- Provider Enumeration Date: 12/04/2015
- Last Update Date: 12/08/2015
Medicare PECOS Information:
- PECOS PAC ID: 1254633639
- Enrollment ID: O20151230002429
Medical Identifiers
Medical identifiers for Bodhi & Sage, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538534359 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 171100000X | Acupuncturist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | 070013559 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Bodhi & Sage, Llc acts as a billing entity for following providers:
| Provider Name | Roger Fong |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1821352915
PECOS PAC ID: 6709188188
Enrollment ID: I20160113000144 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bodhi & Sage, Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Bodhi & Sage, Llc
1525 E 53rd St Ste 808,
Chicago, IL 60615-4583
Ph: () - | Bodhi & Sage, Llc
1525 E 53rd St Ste 808,
Chicago, IL 60615-4583
Ph: (312) 403-1853 |
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