Dr Ellena Lois Boddie, MD is a medicare enrolled "Hospitalist" physician in Lake Mary, Florida. Her current practice location is
525 Technology Park Ste 109, Lake Mary, Florida. You can reach out to her office (for appointments etc.) via phone at
(407) 647-2346.
Dr Ellena Lois Boddie is licensed to practice in Illinois (license number 036116967) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1689673790.
Physician's Profile
| Full Name | Dr Ellena Lois Boddie |
|---|
| Gender | Female |
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| Speciality | |
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| Experience | Years |
|---|
| Location | 525 Technology Park Ste 109, Lake Mary, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr Ellena Lois Boddie attended and graduated from in
NPI Data:
- NPI Number: 1689673790
- Provider Enumeration Date: 07/20/2005
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Ellena Lois Boddie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689673790 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 4301502442 (Michigan) | Secondary |
| 207R00000X | Internal Medicine | 13001A (Wyoming) | Secondary |
| 208M00000X | Hospitalist | 036116967 (Illinois) | Primary |
| 207R00000X | Internal Medicine | TM2020-0627 (New Mexico) | Secondary |
| 207R00000X | Internal Medicine | 036116967 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | M15405 (Idaho) | Secondary |
| 207R00000X | Internal Medicine | 00041414 (Alabama) | Secondary |
| 207R00000X | Internal Medicine | ME146842 (Florida) | Secondary |
| 207R00000X | Internal Medicine | 01057385A (Indiana) | Secondary |
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. Dr Ellena Lois Boddie 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 |
|---|
Dr Ellena Lois Boddie, MD
525 Technology Park Ste 109,
Lake Mary, FL 32746-7107
Ph: (407) 647-2346 | Dr Ellena Lois Boddie, MD
525 Technology Park Ste 109,
Lake Mary, FL 32746-7107
Ph: (407) 647-2346 |
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