Individual provider Active NPI

Matthew Dennis Bogard, M.D.

  • Emergency Medicine Physician
  • Omaha, NE
National Provider Identifier
1225356470
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
26236 Issued in NE
Practice address
983075 Nebraska Medical Ctr
Omaha, NE 68198-3075
Phone
(402) 559-7200
NPI assigned
May 12, 2010
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 40195 IA
Emergency Medicine Physician 207P00000X 26236 NE Primary
Family Medicine Physician 207Q00000X 6219 NE

Addresses

Primary practice location

983075 Nebraska Medical Ctr
Omaha, NE 68198-3075

Mailing address

9609 N 29TH St
Omaha, NE 68112-1523
Phone (402) 690-6604

Other practice location 1

631 N 8th St
Missouri Valley, IA 51555-1102
Phone (712) 624-9278

Other practice location 2

2727 S 144th St
Omaha, NE 68144-5225
Phone (402) 609-1500

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40195IAMDEmergency Medicine Physician
6219NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital Current Accepting new patients
Orthowest LLC Past Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1225356470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9609 N 29TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681121523",
            "telephone_number": "402-690-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983075 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681983075",
            "telephone_number": "402-559-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Missouri Valley",
            "state": "IA",
            "postal_code": "515551102",
            "country_code": "US",
            "telephone_number": "712-624-9278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2727 S 144th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681445225",
            "country_code": "US",
            "telephone_number": "402-609-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGARD",
        "first_name": "MATTHEW",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "40195",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "26236",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "6219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.