Individual provider Active NPI

Patricia Ann Bogema, D.O.

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1407891617
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A9148 Issued in CA
Practice address
2083 Compton Ave Ste 101
Corona, CA 92881-7283
Phone
(951) 268-1001
Fax
(951) 268-1005
NPI assigned
Jun 19, 2006
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A9148 CA Primary

Addresses

Primary practice location

2083 Compton Ave Ste 101
Corona, CA 92881-7283

Mailing address

2083 Compton Ave Ste 101
Corona, CA 92881-7283
Phone (951) 268-1001

Other names 1

  • Ms. Patricia Ann Balsamo Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060907000267 CA Practitioner - Internal Medicine 9436153319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2083 Compton Ave
Suite 203
Corona, CA 92881-3416
Phone (951) 268-1001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9148CAMDInternal Medicine Physician
9148CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Ann Bogema DO Inc Internal Medicine CurrentSince Aug 1, 2010 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Uhs Corona Inc Past Accepting new patients

Locations

2083 Compton Ave
Ste 101
Corona, CA 92881
Phone (951) 898-8515

2083 Compton Ave
Ste 203
Corona, CA 92881
Phone (951) 268-1001

341 Magnolia Ave
Ste 207
Corona, CA 92879
Phone (951) 734-9930

Interoperability endpoints

  • Direct secure messaging: pab102pcs1748@primeclinicalsystems.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1407891617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2083 COMPTON AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817283",
            "telephone_number": "951-268-1001",
            "fax_number": "951-268-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 COMPTON AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817283",
            "telephone_number": "951-268-1001",
            "fax_number": "951-268-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGEMA",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A9148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "BALSAMO",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.