Lisa Bogdonoff, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

180669 Issued in NY

Practice address

123 Grove Ave
Suite 206
Cedarhurst, NY 11516-2322

Phone

(516) 295-3353

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467501767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 GROVE AVE",
            "address_2": "SUITE 206",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 GROVE AVE",
            "address_2": "SUITE 206",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162322",
            "telephone_number": "516-295-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDONOFF",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "180669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloom Ahead, Inc.
• Harriet Bloomberg, LCSW
• Elizabeth Marie Bloxham, DO
• Norman Blumenthal, PHD
• Michelle Bobker, LMHC
• Gavriella Bohan
• Zelda Bokow
• Patricia Anne Boland, R.N.
• Alla Boohoff, D.O.
• Boris Serebryansky MD PC

• Psychiatry Physician in Cedarhurst, NY
• Providers in Cedarhurst, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.