John R. Bogdasarian, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

33995 Issued in MA

Practice address

33 Electric Ave
Fitchburg, MA 01420-7954

Phone

(978) 342-1200

Fax

(978) 345-8014

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• ENT Associates

  • Otolaryngology Physician
  • Fitchburg, MA
  • NPI 1215374178
  NPD (past) Authorized official
• Community Health and Immunization Services, LLC

  • Community Health Worker
  • Phoenix, AZ
  • NPI 1497154090
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1265429617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ELECTRIC AVENUE",
            "address_2": "SUITE 202",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "978-342-1200",
            "fax_number": "978-345-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 ELECTRIC AVE",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207954",
            "telephone_number": "978-342-1200",
            "fax_number": "978-345-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDASARIAN",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "33995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2064111",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Blood, LPN
• Blueprint Healthcare LLC
• Blueprint Healthcare Medical Group Pain Management
• Kwabena Boakye, RPH
• Diandra Boddie
• Nancy E Bohan-Broderick, FNP-BC
• John Edwin Bohlin, M.A.
• Krystina Kacee Bonilla, FNP-BC
• Rachel Ann Bordieri
• Joan Marie Boria, LMHC

• Otolaryngology Physician in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Otolaryngology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.