Bogdanovski, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS11535 Issued in FL

Legal business name

BOGDANOVSKI, PLLC

Practice address

909 Sterthaus Dr
Ormond Beach, FL 32174-5133

Phone

(386) 673-1717

Fax

(386) 672-7819

NPI assigned

Dec 14, 2013

Last updated

Dec 14, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Suzana Bogdanovska, DO

Title

Manager

Phone

(386) 673-1717

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dragi Bogdanovski, D.O.

  • Family Medicine Physician
  • Ormond Beach, FL
  • NPI 1144462102
  Medicare reassignment NPD
• Daniela Bogdanovska, PA-C

  • Medical Physician Assistant
  • Ormond Beach, FL
  • NPI 1174306344
  Medicare reassignment

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

{
    "created_epoch": "1386979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386979200000",
    "number": "1235550419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 STERTHAUS DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745133",
            "telephone_number": "386-673-1717",
            "fax_number": "386-672-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 STERTHAUS DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745133",
            "telephone_number": "386-673-1717",
            "fax_number": "386-672-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOGDANOVSKI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-14",
        "last_updated": "2013-12-14",
        "status": "A",
        "authorized_official_last_name": "BOGDANOVSKA",
        "authorized_official_first_name": "SUZANA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "386-673-1717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Waves Primary Care LLC
• Journee Body
• Lauren Kaycie Boehm, LCSW
• Daniela Bogdanovska, PA-C
• Dragi Bogdanovski, D.O.
• Nicole Bogue, LCSW
• Nicholas Bohan
• Richard Wayne Bolt III, PHARMD
• Julie Bom Conselho, ARNP
• Ramin D Bonnet, DO

• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.