Individual provider Active NPI

Patrick Bogard, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Omaha, NE
National Provider Identifier
1386693455
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
15641 Issued in NE
Practice address
4955 F Street
Omaha, NE 68117
Phone
(402) 717-2871
Fax
(402) 717-5231
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 15641 NE
Cytopathology Physician 207ZC0500X 22053 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 15641 NE Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 22053 IA

Addresses

Primary practice location

4955 F Street
Omaha, NE 68117

Mailing address

PO Box 4907
Omaha, NE 68104
Phone (800) 831-2402

Other identifiers 2

IdentifierTypeStateIssuer
220022265OtherNERR MEDICARE
44195OtherIABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100903000882 NE Practitioner - Pathology 5991829434 Reassigns benefits to 1 organization
I20100903000895 IA Practitioner - Pathology 5991829434 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22053IAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
15641NEMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Mar 1, 2015 Accepting new patients
Lincoln Digestive Health Center LLC PastSince Dec 15, 2010 Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

3308 Samson Way
Bellevue, NE 68123
Phone (402) 291-3373

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

4955 F St
Omaha, NE 68117
Phone (402) 717-2871

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7500 Mercy Rd
Omaha, NE 68124
Phone (402) 398-5880

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1386693455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4907",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68104",
            "telephone_number": "800-831-2402",
            "fax_number": "770-666-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 F STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68117",
            "telephone_number": "402-717-2871",
            "fax_number": "402-717-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGARD",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NE",
            "license": "15641",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "IA",
            "license": "22053",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NE",
            "license": "15641",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "22053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "220022265",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "44195",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.