NPIMap

Individual provider Active NPI

Samantha Jo Bogdan, DO

  • Sports Medicine (Family Medicine) Physician
  • Quakertown, PA
National Provider Identifier
1417484692
Registry record updated Jan 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS021108 Issued in PA
Practice address
1021 Park Ave
Quakertown, PA 18951-0130
Phone
(215) 538-4690
Fax
(866) 410-3429
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS021108 PA
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X OS021108 PA Primary

Addresses

Primary practice location

1021 Park Ave
Quakertown, PA 18951-0130

Mailing address

1021 Park Ave Ste 101
Quakertown, PA 18951-1573
Phone (155) 367-9982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615001863 PA Practitioner - Family Practice 2062812985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group Inc 2,161 clinicians

Practice addresses (Care Compare)

1021 Park Ave
Suite 101
Quakertown, PA 18951-1573
Phone (215) 536-7998

Hospital & facility affiliations

  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS021108PAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Family Medicine Current Accepting new patients
St Luke'S Physician Group Inc Family Medicine CurrentSince Jul 1, 2021 Accepting new patients
St. Luke'S Physician Group Inc. Family Medicine CurrentSince Jul 1, 2021 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1021 Park Ave
Ste 203
Quakertown, PA 18951
Phone (215) 529-6460

1021 Park Ave
Ste 101
Quakertown, PA 18951
Phone (215) 536-7998

Interoperability endpoints

  • Direct secure messaging: samantha.bogdan@slpg.direct-sluhn.org

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1417484692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 PARK AVE STE 101",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189511573",
            "telephone_number": "155-367-9982",
            "fax_number": "215-538-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 PARK AVE",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189510130",
            "telephone_number": "215-538-4690",
            "fax_number": "866-410-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDAN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021108",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS021108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quakertown, PA

Sources for this page

Verify at the official NPI Registry.