Individual provider Active NPI

Matthew Bogdanski, PA-C

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1679113567
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116085 Issued in FL
Practice address
2100 SE Salerno Rd
Stuart, FL 34997-6503
Phone
(772) 223-2300
NPI assigned
Jan 9, 2020
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA061426 PA
Physician Assistant 363A00000X PA9116085 FL Primary

Addresses

Primary practice location

2100 SE Salerno Rd
Stuart, FL 34997-6503

Mailing address

2100 SE Salerno Rd
Stuart, FL 34997-6503
Phone (772) 223-2300

Other practice location 1

620 Howard Ave
Altoona, PA 16601-4804
Phone (814) 889-2011

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220720001681 FL Practitioner - Physician Assistant 5597193250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100

11600 SE Federal Hwy
Hobe Sound, FL 33455-5213
Phone (772) 223-4943

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 223-5665

2100 SE Salerno Rd
Stuart, FL 34997-6503
Phone (772) 223-2300

509 SE Riverside Dr
Stuart, FL 34994-2579

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Martin Memorial Medical Center Inc Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mbogdanski2496322@direct.ccf.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.

Hospital & facility affiliations 2

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1679113567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976503",
            "telephone_number": "772-223-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976503",
            "telephone_number": "772-223-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Howard Ave",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "PA",
            "postal_code": "166014804",
            "country_code": "US",
            "telephone_number": "814-889-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGDANSKI",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061426",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.