Jodie L Bogomilsky, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A055325 Issued in CA

Practice address

888 Oak Grove Ave
Suite 8
Menlo Park, CA 94025-4432

Phone

(650) 325-1511

Fax

(650) 617-1079

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Dermatology

Education

University of California, Davis School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Menlo Dermatology Medical Group and Laser Center IncGroup PAC ID 9537108584, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Menlo Dermatology Medical Group and Laser Center Inc

  • Specialist
  • Menlo Park, CA
  • NPI 1275509465
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104849710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 OAK GROVE AVE",
            "address_2": "SUITE 8",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254432",
            "telephone_number": "650-325-1511",
            "fax_number": "650-617-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 OAK GROVE AVE",
            "address_2": "SUITE 8",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254432",
            "telephone_number": "650-325-1511",
            "fax_number": "650-617-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOMILSKY",
        "first_name": "JODIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A055325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Gerald Bloch, ACSW
• Daniel Michael Blonigen, PH.D.
• Laura Michele Blue, BSN
• Jessica Bocca, LCSW
• David N. Bogart, P.T.
• Samantha Bona
• Adeline Bortz
• Jeane Bosch, PHD
• Nicholas T Bott, PSY.D.
• Melissa Christina Bourbonniere, OTRL

• Specialist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.