Individual provider Active NPI

Smadar Ronen Bogardus, MD

  • Surgery Physician
  • Troy, NY
National Provider Identifier
1104386465
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
327311 Issued in NY
Practice address
2231 Burdett Ave Ste 230
Troy, NY 12180-2447
Phone
(518) 271-5527
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 327311 NY Primary

Addresses

Primary practice location

2231 Burdett Ave Ste 230
Troy, NY 12180-2447

Mailing address

PO Box 14890
Albany, NY 12212-4890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentailing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240808001795 NY Practitioner - General Surgery 8123358942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

Practice addresses (Care Compare)

2231 Burdett Ave
Suite 230
Troy, NY 12180-2447
Phone (518) 272-7191

Hospital & facility affiliations

  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327311NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Aug 26, 2024 Accepting new patients

Locations

2231 Burdett Ave
Ste 230
Troy, NY 12180
Phone (518) 271-5527

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: sbogardus3500449@direct.trinity-health.org

Organizations & group practices 1

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1104386465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 BURDETT AVE STE 230",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802447",
            "telephone_number": "518-271-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGARDUS",
        "first_name": "SMADAR",
        "middle_name": "RONEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "327311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentailing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "sphp payer credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2231 Burdett Ave Ste 230",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.