Bradley Phillip Bogdan, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

8441 State Highway 47 Ste 1400
Bryan, TX 77807-3208

Phone

(979) 776-8440

Fax

(877) 601-5854

NPI assigned

Oct 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Texas a&M University System Health Science Center

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1063699312
  Medicare reassignment NPD
• Mhmra of Brazos Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bryan, TX
  • NPI 1881621225
  Medicare reassignment
• Texas a&M University System Health Science Center

  • Rural Health Clinic/Center
  • Navasota, TX
  • NPI 1558140004
  NPD

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1487907366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST STE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022623",
            "telephone_number": "979-436-0483",
            "fax_number": "877-601-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 STATE HIGHWAY 47 STE 1400",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778073208",
            "telephone_number": "979-776-8440",
            "fax_number": "877-601-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 4th St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955010325",
            "country_code": "US",
            "telephone_number": "707-442-4322 x127",
            "fax_number": "707-442-4113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGDAN",
        "first_name": "BRADLEY",
        "middle_name": "PHILLIP",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-17",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361416602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angie Bleike, LPC
• Sophia Blossom, LPC
• Blue Sky Orthotic and Prosthetics
• Markitta Blue
• Heather Renee Blum, MT
• Elizabeth Boggess, LPC
• Henry Bohne, MD
• Rodney Kipruto Boit, MD
• Grace Mary Boland
• Paul V Bonarrigo, LPT, PC

• Clinical Social Worker in Bryan, TX
• Providers in Bryan, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.