Individual provider Active NPI

Bogdan Ioannis Patedakis Litvinov, MD

  • Clinical Neurophysiology Physician
  • New Haven, CT
National Provider Identifier
1255868238
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
68138 Issued in CT
Practice address
15 York Street
Lci 910
New Haven, CT 06520-8018
Phone
(203) 785-4085
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 68138 CT Primary

Addresses

Primary practice location

15 York Street
Lci 910
New Haven, CT 06520-8018

Mailing address

15 York Street
Lci 910
New Haven, CT 06520-8018
Phone (203) 785-4085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230809003127 CT Practitioner - NeurologyPractitioner - Epileptologists 3971873001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Epileptologists
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

Hospital & facility affiliations

  • Bridgeport Hospital Hospital, Bridgeport, CT, CCN 070010
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Current Accepting new patients
Yale University CurrentSince Jul 1, 2023 Accepting new patients
Yale University CurrentSince Jul 1, 2023 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

15 York St
#910
New Haven, CT 06510
Phone (203) 785-4085

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: bpatedakislitvinov368337@direct.ynhh.org

Organizations & group practices 3

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 4

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255868238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORK STREET",
            "address_2": "LCI 910",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208018",
            "telephone_number": "203-785-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 YORK STREET",
            "address_2": "LCI 910",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208018",
            "telephone_number": "203-785-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEDAKIS LITVINOV",
        "first_name": "BOGDAN",
        "middle_name": "IOANNIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CT",
            "license": "68138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.