Active NPI
Bradley John Boget, DO
- Surgery Physician
- Jeffersonville, IN
National Provider Identifier
1629659545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 02008853A
- 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, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210622001737 | MI | Order and Referring Only - 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medical Associates, Inc. | Past | Accepting new patients | |
| Community Medical Associates, Inc. | Surgery | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
dba Norton Community Medical Associates
- Internal Medicine Physician
- Louisville, KY
- NPI 1881192409
-
- Neurological Surgery Physician
- Louisville, KY
- NPI 1922288760
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.