Robert M. Bogdasarian, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4961 Issued in MA

Practice address

460 Southbridge St
Auburn, MA 01501-2442

Phone

(774) 221-5135

Fax

(774) 221-5136

NPI assigned

Mar 12, 2014

Last updated

Mar 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dispatchhealth Massachusetts PCGroup PAC ID 0840542791, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.bogdasarian.1@13869.direct.athenahealth.com

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.

• Dispatchhealth Massachusetts PC

  • Emergency Medicine Physician
  • Auburn, MA
  • NPI 1629555842
  Medicare reassignment Care Compare group
• Athol Memorial Hospital Incorporated

  • Critical Access Hospital
  • Athol, MA
  • NPI 1336120047
  Medicare reassignment
• Henry Heywood Memorial Hospital

  dba Heywood Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Medicare reassignment
• Henry Heywood Memorial Hospital

  dba Heywood Hospital

  • Psychiatric Hospital Unit
  • Gardner, MA
  • NPI 1457685299
  NPD
• Excella Home Health Agency, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Ludlow, MA
  • NPI 1356642110
  NPD (past)
• Reliant Medical Group, Inc

  • Physical Therapist
  • Worcester, MA
  • NPI 1295827962
  NPD (past)

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1063838258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-368-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 SOUTHBRIDGE ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012442",
            "telephone_number": "774-221-5135",
            "fax_number": "774-221-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDASARIAN",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-12",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110105900A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• William John Bowes, MSC LSW
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• Destiny Bradley

• Physician Assistant in Auburn, MA
• Providers in Auburn, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.