Individual provider Active NPI

Bradley John Boget, DO

  • Surgery Physician
  • Jeffersonville, IN
National Provider Identifier
1629659545
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
02008853A Issued in IN
Practice address
301 Gordon Gutmann Blvd Ste 401
Jeffersonville, IN 47130-3768
Phone
(812) 282-0637
Fax
(812) 283-6630
NPI assigned
Apr 21, 2021
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151014822 MI
Surgery Physician 208600000X 06253 KY
Surgery Physician 208600000X 02008853A IN Primary

Addresses

Primary practice location

301 Gordon Gutmann Blvd Ste 401
Jeffersonville, IN 47130-3768

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 975-2219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210622001737 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 8426459959

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Marian University College of Osteopathic Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1951 Bishop LN
FL 4
Louisville, KY 40218-1923

PO Box
Suite 776351
Chicago, IL 60677-6351

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. PastSince Aug 1, 2026 Accepting new patients
Community Medical Associates, Inc. Surgery PastSince Aug 1, 2026 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bboget866364@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1629659545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-975-2219",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GORDON GUTMANN BLVD STE 401",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303768",
            "telephone_number": "812-282-0637",
            "fax_number": "812-283-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGET",
        "first_name": "BRADLEY",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151014822",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "06253",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "02008853A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.