Brian F Bovino, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

040518 Issued in NY

Practice address

425 W 59TH St
10TH Floor
New York, NY 10019-1104

Phone

(212) 523-7791

Fax

(212) 523-8165

NPI assigned

Dec 6, 2006

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

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: bbovino3519262@nychhc.direct-ci.com

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.

• Icahn School of Medicine at Mount Sinai

  • Pediatrics Physician
  • New York, NY
  • NPI 1275802811
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Otolaryngology Physician
  • New York, NY
  • NPI 1538407176
  NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • New York, NY
  • NPI 1073535027

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1659430643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HIDDEN GLEN RD",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581722",
            "telephone_number": "201-818-6953",
            "fax_number": "201-818-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191104",
            "telephone_number": "212-523-7791",
            "fax_number": "212-523-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVINO",
        "first_name": "BRIAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "040518",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "015109",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01285336",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chanette Charolette Bovell, LMSW-LP
• Elise Lingbo Boventer, MD, MPH
• Gregory Paul Bovenzi
• Matthew David Bovenzi, O.D.
• Debra Bovian, CASAC
• Mary Ellen Bovino, RN
• Thomas Edward Bow, M.A., L.C.S.W.
• Hillary Ann Bowden, LMHC
• Kathleen Ellen Bowden, LCSW
• Shannon Bowden

• Oral and Maxillofacial Surgery (Dentist) in New York, NY
• Providers in New York, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.