David Bogolub, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Practice address

2100 Madison Ave
Granite City, IL 62040-4701

Phone

(618) 798-3000

Fax

(618) 798-3885

NPI assigned

Jun 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 VI

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

Emergency Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Governor Juan F Luis Hospital and Medical CenterGroup PAC ID 1153233804, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gov Juan F Luis Hospital & Medical Ctr Hospital, St Croix, VI, CCN 480002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Medicare reassignment Care Compare group NPD
• Governor Juan F. Luis Hospital & Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • St Croix, VI
  • NPI 1740238534
  NPD
• Cottage Emergency Physicians LLC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1790723724
  NPD (past)
• Emergency Room Care Providers, S.C.

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1417990219
  NPD (past)
• Kennekuk Emergency Physicians LLC

  • Emergency Medicine Physician
  • Danville, IL
  • NPI 1659523777
  NPD (past)

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

• Governor Juan F. Luis Hospital & Medical Center

  • General Acute Care Hospital
  • Christiansted, St. Croix, VI
  • NPI 1972503647
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245279181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3836 N TRIPP AVE",
            "address_2": "XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413011",
            "telephone_number": "630-941-4330",
            "fax_number": "630-941-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404701",
            "telephone_number": "618-798-3000",
            "fax_number": "618-798-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOLUB",
        "first_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bijoy Hegde MD, PC
• Bill F. McMasters DDS LTD
• Biomedical Imaging LLC
• Biomedical Imaging, LLC
• Erin K Boerm, MS OTR/L
• Shanya Leshay Bond
• Jonathan Botterbush, PHARMD
• Melissa Lee Bounds, NP
• Adriene Marie Boyd, LSW
• Brad McMillin Inc (Beltone Hearing Aid Service)

• Emergency Medicine Physician in Granite City, IL
• Providers in Granite City, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.