Individual provider Active NPI

Aleksey V Bogolyubov, MD

  • Pulmonary Disease Physician
  • Utica, NY
National Provider Identifier
1245339001
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
017228 Issued in ME
Practice address
35 Riverside Dr
Utica, NY 13502-2320
Phone
(315) 735-2294
Fax
(315) 624-8412
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 017228 ME Primary

Addresses

Primary practice location

35 Riverside Dr
Utica, NY 13502-2320

Mailing address

2209 Genesee St
Business Office Room 315
Utica, NY 13502
Phone (315) 801-8534

Other names 1

  • Alexei V Bogolioubov Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20220413002321 NY Practitioner - Pulmonary Disease 5193722767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

35 Riverside Dr
Utica, NY 13502-2320
Phone (315) 624-8400

Hospital & facility affiliations

  • Wynn Hospital Hospital, Utica, NY, CCN 330044

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017228MEMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Apr 18, 2022 Accepting new patients
MVHS Inc CurrentSince Apr 18, 2022 Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

35 Riverside Dr
Utica, NY 13502
Phone (315) 624-8400

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: abogolioubov34935@mvhealthsystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1245339001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GENESEE ST",
            "address_2": "BUSINESS OFFICE ROOM 315",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-801-8534",
            "fax_number": "315-801-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 RIVERSIDE DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135022320",
            "telephone_number": "315-735-2294",
            "fax_number": "315-624-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOLYUBOV",
        "first_name": "ALEKSEY",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-04-14",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "ME",
            "license": "017228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXEI",
            "last_name": "BOGOLIOUBOV",
            "middle_name": "V",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.