Individual provider Active NPI

Andrzej S. Boguszewski, M.D.

  • Interventional Cardiology Physician
  • Midland, MI
National Provider Identifier
1063580595
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
4301077917 Issued in MI
Practice address
301 W Wackerly St
Midland, MI 48640-2761
Phone
(989) 832-0900
NPI assigned
Dec 1, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301077917 MI
Cardiovascular Disease Physician 207RC0000X 4301077917 MI
Nuclear Cardiology Physician 207UN0901X 4301077917 MI
Interventional Cardiology Physician 207RI0011X 4301077917 MI Primary

Addresses

Primary practice location

301 W Wackerly St
Midland, MI 48640-2761

Mailing address

301 W Wackerly St
Midland, MI 48640-2761
Phone (989) 832-0900

Other identifiers 1

IdentifierTypeStateIssuer
4301077917OtherMIPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000223 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Peripheral Vascular Disease 1254304512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

170 N Caseville Rd
Pigeion, MI 48755-9704
Phone (989) 839-3538

200 Hemlock Rd
Tawas City, MI 48763-2000
Phone (989) 839-3060

2660 W Sugnet Rd
Midland, MI 48640-2647

300 E Warwick Dr
Alma, MI 48801-1014
Phone (989) 463-1101

320 E Warwick Dr
Wound Treatment Center
Alma, MI 48801-1014
Phone (989) 466-7020

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

515 Quarter St
Gladwin, MI 48624-1959
Phone (989) 426-9286

703 N McEwan St
Clare, MI 48617-1440
Phone (989) 802-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting52
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301077917MIMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland Current Accepting new patients
Mymichigan Medical Center Midland CurrentSince Aug 1, 2014 Accepting new patients
Mymichigan Medical Center Midland Internal Medicine CurrentSince Aug 1, 2014 Accepting new patients

Locations

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

602 Beech St
Ste 1230
Clare, MI 48617
Phone (989) 802-8415

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

9249 W Lake City Rd
Houghton Lake, MI 48629
Phone (989) 422-2183

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

2660 W Sugnet Rd
Midland, MI 48640
Phone (989) 488-5010

301 W Wackerly St
Midland, MI 48640
Phone (989) 488-5850

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4401 N Campus Ridge Dr
Ste C2100
Midland, MI 48640
Phone (989) 837-9033

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

170 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-3223

Interoperability endpoints

  • Direct secure messaging: aboguszewski371693@direct.hfhs.org
  • Direct secure messaging: aboguszewski6260@mymichiganhealth.midirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063580595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402761",
            "telephone_number": "989-832-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402761",
            "telephone_number": "989-832-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUSZEWSKI",
        "first_name": "ANDRZEJ",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301077917",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301077917",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MI",
            "license": "4301077917",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301077917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301077917",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.