Active NPI
Michelle Alex Bogdan
- Pediatrics Physician
- Astoria, NY
National Provider Identifier
1154884997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 317925
- Practice address
- 3157 31St St
Astoria, NY 11106-2593 - Phone
- (347) 569-6005
- NPI assigned
- Apr 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 317925 | NY | Primary |
Addresses
Primary practice location
3157 31St St
Astoria, NY 11106-2593
Mailing address
3157 31St St
Astoria, NY 11106-2593
Phone (347) 569-6005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 317925 | NY | MD | Pediatrics Physician |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1154884997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3157 31ST ST",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111062593",
"telephone_number": "347-569-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3157 31ST ST",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111062593",
"telephone_number": "347-569-6005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGDAN",
"first_name": "MICHELLE",
"middle_name": "ALEX",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-09",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "317925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.