Panagiotis P Bougas, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G84424 Issued in CA

Practice address

220 Laguna Rd
Suite 2
Fullerton, CA 92835-2523

Phone

(714) 446-7454

Fax

(714) 879-1049

NPI assigned

Nov 2, 2006

Last updated

May 12, 2015By 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 3

Addresses

Other identifiers 4

Other names 1

• Panagiotis P Mpougas Other name

Medicare fee-for-service enrollment

Enrolled in CA

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

Critical Care (Intensivists)Also: Pulmonary Disease

Education

University of Colorado School of Medicine, Denver, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pbougas423600@direct.llu.edu

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Av Critical Care Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Lancaster, CA
  • NPI 1144723800
  Medicare reassignment NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Hematology & Oncology Physician
  • Orange, CA
  • NPI 1801443510
  NPD
• Ahmc Whittier Hospital Medical Center LP

  dba Whittier Hospital Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Whittier, CA
  • NPI 1497855605
  NPD (past)
• Ravi S Shankar MD Professional Corp

  • Pulmonary Disease Physician
  • Lancaster, CA
  • NPI 1326139932
  NPD (past)
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)
• Western Pulmonary Medical Group Inc

  • Pulmonary Disease Physician
  • Irvine, CA
  • NPI 1104905199

  Internal Medicine

  NPD (past)

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

• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  dba Providence St. Jude Medical Center

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1295814275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 LAGUNA RD",
            "address_2": "SUITE 2",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352523",
            "telephone_number": "714-446-7454",
            "fax_number": "714-879-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LAGUNA RD",
            "address_2": "SUITE 2",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352523",
            "telephone_number": "714-446-7454",
            "fax_number": "714-879-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGAS",
        "first_name": "PANAGIOTIS",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G84424",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G84424",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G84424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290011505",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROV I.D.",
            "identifier": "GR0014371",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G84424",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ97067Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PANAGIOTIS",
            "last_name": "MPOUGAS",
            "middle_name": "P",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bradley Borsari, MD
• Christina M Borsari, MD
• Eric Jeffery Borsting, OD
• Eugene Boston
• Richard Donald Boucher, M.D.
• Kate S. Boulder, DNP, FNP-C, AGNP-C
• Michelle Bowers
• Jinhi Bowman, D.C.
• McKenna Bowman
• Deanna Box

• Internal Medicine Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.