BLAKE MICHAEL BODENDORFER M.D.
NPI 1083000905
Orthopaedic Surgery - Sports Medicine in Council Bluffs, IA

Q: What is Blake Bodendorfer's NPI number?

The NPI number for Blake Bodendorfer is 1083000905. It was assigned to this individual provider in the NPPES registry on April 7, 2015.

Q: What is Blake Bodendorfer's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Blake Bodendorfer was last updated on August 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 07, 2015PECOS Enrolled

1 EDMUNDSON PL STE 500, COUNCIL BLUFFS, IA 51503(712) 323-5333 Get Directions Write a Review

NPPES record last updated: August 2, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 2, 2021, Jun 5, 2020 (2 updates tracked since 2020).

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About Blake Michael Bodendorfer M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE MICHAEL BODENDORFER M.D. (NPI 1083000905) is an individual sports medicine provider in Council Bluffs, Iowa, licensed in Illinois (036152051) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Methodist Jennie Edmundson, and is a graduate of University Of Missouri, Columbia School Of Medicine (2015).

NPPES Registry Identity

NPI1083000905

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameBLAKE MICHAEL BODENDORFERCredential: M.D.

Location Address1 EDMUNDSON PL STE 500Council Bluffs, IA 51503-4619

Mailing Address1611 W Harrison St Ste 400Chicago, IL 60612-4861 · (312) 432-2351 · Fax (708) 409-5179

Phone(712) 323-5333

Sole ProprietorYes

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 2015

Enumeration DateApril 7, 2015

Last NPPES UpdateAugust 2, 20212 updates tracked since enumeration

NPPES CertifiedAugust 2, 2021

✔ NPI 1083000905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in IL · 036152051

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

1 EDMUNDSON PL STE 500, Council Bluffs, IA 51503

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blake Michael Bodendorfer M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547686313

PECOS Enrollment IDI20210709002703, I20210817002235

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Blake Bodendorfer reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Alegent Creighton Clinic

0.2 mi

Family Medicine

800 MERCY DR
Council Bluffs, IA 51503

Reassigned Medicare billing, Iowa and Nebraska enrollments
Also billed through NPI 1548287907 (Nebraska)
482 clinicians in this Medicare group

NPI 1598811069 (855) 524-4001

MD West One, PC

11 mi

Neurological Surgery

8005 FARNAM DR STE 305
Omaha, NE 68114

Reassigned Medicare billing, Iowa and Nebraska enrollments
33 clinicians in this Medicare group

NPI 1588616767 (402) 390-4111

Montgomery County Memorial Hospital

36 mi

Critical Access

2301 EASTERN AVE
Red Oak, IA 51566

Reassigned Medicare billing, Iowa enrollment
Also billed through NPI 1265405310 (Iowa)
67 clinicians in this Medicare group

NPI 1376539338 (712) 623-7000

Shelby County Chris A Myrtue Memorial Hospital

37 mi

Critical Access

1213 GARFIELD AVE
Harlan, IA 51537

Reassigned Medicare billing, Iowa enrollment
Also billed through NPI 1831717552 (Iowa)
70 clinicians in this Medicare group

NPI 1598871469 (712) 755-5161

Community Hospital Inc

46 mi

Emergency Medicine

2959 US HIGHWAY 275
Hamburg, IA 51640

Reassigned Medicare billing, Iowa enrollment
Also billed through NPI 1932294071 (Iowa)
6 clinicians in this Medicare group

NPI 1124112677 (712) 382-1515

Clarinda Regional Health Center

56 mi

Family Medicine

220 ESSIE DAVISON DR.
Clarinda, IA 51632

Reassigned Medicare billing, Iowa enrollment
130 clinicians in this Medicare group

NPI 1629196241 (712) 542-8330

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

150 services60 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

81 services62 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

71 services52 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

61 services49 patients

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

56 services49 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

51 services51 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

20 services20 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

20 services13 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

20 services20 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

19 services17 patients

Repair of chronic torn shoulder rotator cuff 23412

Repair of a chronic torn shoulder rotator cuff is a surgical procedure aimed at mending the damaged tendon in your shoulder. This helps restore shoulder strength and functionality, alleviating pain and discomfort caused by the tear.

13 services13 patients

Anchoring of biceps tendon 23430

Anchoring of the biceps tendon is a surgical procedure aimed at restoring stability to your arm. The surgeon secures your biceps tendon to the bone using special anchors, which helps to reduce pain and improve arm function.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Jennie Edmundson

Acute Care Hospitals · Council Bluffs, IA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number160047

Location933 East Pierce StreetCouncil Bluffs, IA 51503 · Pottawattamie County

Emergency services Birthing friendly

Myrtue Medical Center

Critical Access Hospitals · Harlan, IA

5/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number161374

Location1213 Garfield AvenueHarlan, IA 51537 · Shelby County

Emergency services Birthing friendly

The Nebraska Methodist Hospital

Acute Care Hospitals · Omaha, NE

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number280040

Location8303 Dodge StOmaha, NE 68114 · Douglas County

Emergency services Birthing friendly

Chi Health Midlands

Acute Care Hospitals · Papillion, NE

OwnershipVoluntary non-profit - Church

CMS Certification Number280105

Location11111 South 84th StPapillion, NE 68046 · Sarpy County

Emergency services

Chi Health Lakeside

Acute Care Hospitals · Omaha, NE

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number280130

Location16901 Lakeside Hills CtOmaha, NE 68130 · Douglas County

Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

5 suppliers31 claims31 services$111.15 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Bodendorfer's NPI number?

The NPI number for Blake Bodendorfer is 1083000905. It was assigned to this individual provider in the NPPES registry on April 7, 2015.

Where is Blake Bodendorfer located?

Blake Bodendorfer practices at 1 Edmundson Pl Ste 500, Council Bluffs, IA 51503. The listed phone number is (712) 323-5333.

What is Blake Bodendorfer's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Blake Bodendorfer enrolled in Medicare?

Yes. Blake Bodendorfer is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Blake Bodendorfer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blake Bodendorfer reassigns Medicare benefits to 6 organizations: Alegent Creighton Clinic (Council Bluffs, IA), MD West One, PC (Omaha, NE), Montgomery County Memorial Hospital (Red Oak, IA), Shelby County Chris A Myrtue Memorial Hospital (Harlan, IA), Community Hospital Inc (Hamburg, IA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blake Bodendorfer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Blake Bodendorfer accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 3 other insurers list Blake Bodendorfer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Blake Bodendorfer affiliated with any hospitals?

According to CMS data, Blake Bodendorfer is affiliated with Methodist Jennie Edmundson, Myrtue Medical Center, The Nebraska Methodist Hospital, Chi Health Midlands and Chi Health Lakeside.

When was this NPI record last updated?

The NPPES record for Blake Bodendorfer was last updated on August 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.