Individual provider Active NPI

Michael Bogart, MD

  • Pulmonary Disease Physician
  • Ridgewood, NJ
National Provider Identifier
1285130989
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA12247400 Issued in NJ
Practice address
1200 E Ridgewood Ave Ste 303
Ridgewood, NJ 07450-3937
Phone
(201) 689-7755
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 312311-01 NY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25MA12247400 NJ
Pulmonary Disease Physician 207RP1001X 312311-01 NY
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X 25MA12247400 NJ Primary

Addresses

Primary practice location

1200 E Ridgewood Ave Ste 303
Ridgewood, NJ 07450-3937

Mailing address

1200 E Ridgewood Ave Ste 303
Ridgewood, NJ 07450-3937
Phone (201) 689-7755

Other practice location 1

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240815000100 NJ Practitioner - Pulmonary Disease 2365980844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12247400NJMDCritical Care Medicine (Internal Medicine) Physician
312311-01NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Aug 12, 2024 Accepting new patients

Locations

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

1200 E Ridgewood Ave
Ste 303
Ridgewood, NJ 07450
Phone (201) 689-7755

1200 E Ridgewood Ave
Ste 303W
Ridgewood, NJ 07450
Phone (201) 689-7755

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mbogart1609408@nychhc.direct-ci.com
  • Direct secure messaging: michael.bogart.1@5622.direct.athenahealth.com

Organizations & group practices 1

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 6

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1285130989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E RIDGEWOOD AVE STE 303",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503937",
            "telephone_number": "201-689-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E RIDGEWOOD AVE STE 303",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503937",
            "telephone_number": "201-689-7755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGART",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "312311-01",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA12247400",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "312311-01",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA12247400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.