Individual provider Active NPI

Paul Bogner, MD

  • Dermatopathology (Pathology) Physician
  • Buffalo, NY
National Provider Identifier
1609871284
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
230797 Issued in NY
Practice address
Elm and Carlton Streets
Buffalo, NY 14263-0001
Phone
(716) 845-2300
Fax
(716) 845-3427
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 230797 NY
Dermatopathology (Pathology) Physician 207ZD0900X 230797 NY Primary

Addresses

Primary practice location

Elm and Carlton Streets
Buffalo, NY 14263-0001

Mailing address

Elm and Carlton Streets
Buffalo, NY 14263-0001
Phone (716) 845-2300

Other identifiers 1

IdentifierTypeStateIssuer
02639509MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050527000232 NY Practitioner - Pathology 7618919804 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
State University of New York at Buffalo School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Williamsville, NY 14221-5269

6420 Transit Rd
Suite a
Depew, NY 14043-1033
Phone (716) 845-1600

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
230797NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Jul 1, 2005 Accepting new patients
Saif Soniwala,M.D.,PC Current Accepting new patients
Roswell Park Cancer Institute CurrentSince Jul 1, 2005 Accepting new patients
Associated Plastic Surgeons of Western New York PC CurrentSince Feb 1, 2013 Accepting new patients
Rpci Oncology PC CurrentSince Jun 1, 2021 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

5611 Main St
Williamsville, NY 14221
Phone (716) 631-8500

5609 Main St
Williamsville, NY 14221
Phone (716) 631-8500

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

Organizations & group practices 5

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 1

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1609871284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON STREETS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON STREETS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142630001",
            "telephone_number": "716-845-2300",
            "fax_number": "716-845-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGNER",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "230797",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NY",
            "license": "230797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02639509",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.