Individual provider Active NPI

Dan Argin Boggus, MD

  • Family Medicine Physician
  • Tavares, FL
National Provider Identifier
1669419248
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME42891 Issued in FL
Practice address
1755 David Walker Dr
Tavares, FL 32778-5745
Phone
(352) 742-8830
Fax
(352) 742-8826
NPI assigned
Jun 1, 2006
Last updated
Aug 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME42891 FL Primary

Addresses

Primary practice location

1755 David Walker Dr
Tavares, FL 32778-5745

Mailing address

1755 David Walker Dr
Tavares, FL 32778-5745
Phone (352) 742-8830

Other identifiers 1

IdentifierTypeStateIssuer
35208OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100215000529 FL Practitioner - Family Practice 2062303316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Medical Group LLCGroup PAC ID 8022324862, 20 clinicians

Practice addresses (Care Compare)

1733 David Walker Dr
Tavares, FL 32778-5745
Phone (352) 508-1830

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME42891FLMDFamily Medicine Physician
42891FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Medical Group LLC CurrentSince Jun 1, 2018 Accepting new patients

Locations

410 Fern Dr
Leesburg, FL 34748
Phone (352) 218-8200

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

1733 David Walker Dr
Tavares, FL 32778
Phone (352) 508-1830

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dan.boggus@amgamg.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1669419248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-742-8830",
            "fax_number": "352-742-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 DAVID WALKER DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785745",
            "telephone_number": "352-742-8830",
            "fax_number": "352-742-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGUS",
        "first_name": "DAN",
        "middle_name": "ARGIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME42891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35208",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.