Kishanrao Bogavelli, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MA44068 Issued in NJ

Practice address

680 Broadway
Paterson, NJ 07514-1422

Phone

(973) 977-6603

NPI assigned

May 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hogarth Emergency Physicians

  • Emergency Medicine Physician
  • Newton, NJ
  • NPI 1770532343
  NPD (past)
• South Jersey Health System Emergency Physician Services P a

  • Emergency Medicine Physician
  • Elmer, NJ
  • NPI 1306871314
  NPD (past)
• Keystone Medical Services of New York, PC

  • Emergency Medicine Physician
  • Springville, NY
  • NPI 1952331761
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538371745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD",
            "address_2": "STE 102",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535557",
            "telephone_number": "845-565-3700",
            "fax_number": "845-565-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141422",
            "telephone_number": "973-977-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAVELLI",
        "first_name": "KISHANRAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MA44068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myron I Bloch, O. D.
• Blooming Pharmacy LLC
• Blue River Women's Health PA
• Blue Star Urgent Care
• Monica Anne Mary Domantay Bobila, MD
• Maged Boghdady, M.D.
• Janardhan Bollu, MD
• Maryanne Bolton, DNP, RN., APN-BC
• Veera Jayasree Latha Bommu, MBBS
• Kunal Bonde

• Emergency Medicine Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Emergency Medicine Physician in New Jersey

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.