GWENDOLYN BODNER
NPI 1558210500
Student in an Organized Health Care Education/Training Program in Selinsgrove, PA

Q: What is Gwendolyn Bodner's NPI number?

The NPI number for Gwendolyn Bodner is 1558210500. It was assigned to this individual provider in the NPPES registry on January 23, 2026.

Q: What is Gwendolyn Bodner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Gwendolyn Bodner was last updated on March 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 23, 2026PECOS EnrolledAccepts Medicare Assignment

201 ROOSEVELT AVE, SELINSGROVE, PA 17870(570) 374-0151(570) 374-0311 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 9, 2026, Jan 23, 2026 (2 updates tracked since 2026).

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About Gwendolyn Bodner NPPES

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

GWENDOLYN BODNER (NPI 1558210500) is an individual student in an organized health care education/training program in Selinsgrove, Pennsylvania and active in the NPI registry since January 2026. The provider is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1558210500

Entity TypeIndividual

Primary Taxonomy390200000X

Provider Legal NameGWENDOLYN BODNER

Location Address201 ROOSEVELT AVESelinsgrove, PA 17870-7969

Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 374-0151 · Fax (570) 374-0311

Phone(570) 374-0151

Fax(570) 374-0311

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJanuary 23, 2026

Last NPPES UpdateMarch 9, 20262 updates tracked since enumeration

NPPES CertifiedMarch 9, 2026

✔ NPI 1558210500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedPhysician AssistantTaxonomy 363A00000X · License OA007636 (PA)

201 ROOSEVELT AVE, Selinsgrove, PA 17870

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gwendolyn Bodner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638652878

PECOS Enrollment IDI20260316001454

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.

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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PEDRO O. SERVANO III M.D.

Family Medicine