NPIMap

Individual provider Active NPI

Matthew W. Bogart, APRN

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1508320086
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21740 Issued in SC
Practice address
96 Jonathan Lucas Street CSB 822, MSC 624
Charleston, SC 29425-5294
Phone
(843) 985-0999
Fax
(843) 985-9696
NPI assigned
Jan 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21740 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas Street CSB 822, MSC 624
Charleston, SC 29425-5294

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other identifiers 1

IdentifierTypeStateIssuer
NP5764MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20190725002884 SC Practitioner - Nurse Practitioner 8224364443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Mar 10, 2022 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Mar 10, 2022 Accepting new patients

Locations

96 Jonathan Lucas St
#822
Charleston, SC 29425
Phone (843) 792-0547

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

7 S Alliance Dr
Ste 202A
Goose Creek, SC 29445
Phone (843) 376-6070

Interoperability endpoints

  • Direct secure messaging: mbogart45558@direct.musc.edu

Organizations & group practices 2

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 10

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1508320086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS STREET CSB 822, MSC 624",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255294",
            "telephone_number": "843-985-0999",
            "fax_number": "843-985-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGART",
        "first_name": "MATTHEW",
        "middle_name": "W.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-29",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5764",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.