Active NPI
Mary Michelle Bogen, DPM
- Podiatrist
- Venice, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO3104
- Practice address
- 712 The Rialto
Venice, FL 34285-3524 - Phone
- (941) 488-0222
- Fax
- (941) 480-1668
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO3104 | FL | Primary |
Addresses
Primary practice location
712 The Rialto
Venice, FL 34285-3524
Mailing address
712 The Rialto
Venice, FL 34285-3524
Phone (941) 488-0222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U1808A | Other | FL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Barry University School of Podiatric Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391
410 N M St
Choctaw Nation Health Care Hugo
Hugo, OK 74743-1820
Phone (539) 316-6391
902 Lincoln Rd
Choctaw National Health Care Idabel
Idabel, OK 74745-7817
Phone (539) 316-6391
One Choctaw Way
Talihina, OK 74571-2022
Hospital & facility affiliations
- Choctaw Nation Health Services Authority
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.07 of 100
- Quality
- 73.06
- Improvement activities
- 40
- Cost
- 69.92
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 188 |
| Removal or shaving of skin growth | 37 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO3104 | FL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Past | Accepting new patients |
Locations
1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981
1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204
410 N M St
Hugo, OK 74743
Phone (580) 326-7561
902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600
1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026
109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100
2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200
1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440
Interoperability endpoints
- mbogen19667@choctawnation.direct-ci.com
Organizations & group practices 4
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.
-
- Primary Care Clinic/Center
- Durant, OK
- NPI 1396173449
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Broken Bow, OK
- NPI 1447143532
-
- Primary Care Clinic/Center
- Broken Bow, OK
- NPI 1770559619
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Talihina, OK
- NPI 1659347623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1649288663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 THE RIALTO",
"city": "VENICE",
"state": "FL",
"postal_code": "342853524",
"telephone_number": "941-488-0222",
"fax_number": "941-480-1668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 THE RIALTO",
"city": "VENICE",
"state": "FL",
"postal_code": "342853524",
"telephone_number": "941-488-0222",
"fax_number": "941-480-1668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGEN",
"first_name": "MARY",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "FL",
"license": "PO3104",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "U1808A",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.