Bogdan Ristic

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

139 Fremont CT
Hercules, CA 94547-1141

Phone

(510) 318-1537

NPI assigned

Dec 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

85.65 of 100Reported as group

Quality

76.23

Promoting interoperability

100

Improvement activities

40

Cost

75.95

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1608940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1609463538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FREMONT CT",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471141",
            "telephone_number": "510-318-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FREMONT CT",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471141",
            "telephone_number": "510-318-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTIC",
        "first_name": "BOGDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-26",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gavin Reid
• Resource Care One
• S. Gabriel Respicio III, O.D.
• Adonis Reyes
• Haydee Reyes
• Adilia Michelle Rivas
• Monica J Rivera
• Jaheem Robinson X
• Kimberly Rojas
• Karen Rugama

• Physician Assistant in Hercules, CA
• Providers in Hercules, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.