NPIMap

Individual provider Active NPI

Matthew Bogan, M.D.

  • Emergency Medicine Physician
  • Amery, WI
National Provider Identifier
1689088387
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
67094 Issued in WI
Practice address
265 Griffin St E
Amery, WI 54001-1439
Phone
(715) 268-8000
NPI assigned
Jun 20, 2014
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 61905 MN
Emergency Medicine Physician 207P00000X 67094 WI Primary

Addresses

Primary practice location

265 Griffin St E
Amery, WI 54001-1439

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516

Other practice location 1

640 Jackson St # Mc11102F
Saint Paul, MN 55101-2502
Phone (651) 254-5091

Other practice location 2

927 Churchill St W
Stillwater, MN 55082-6605
Phone (651) 439-5330

Other practice location 3

405 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000

Other practice location 4

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170615002032 WI Practitioner - Emergency Medicine 0244508240 Reassigns benefits to 8 organizations
I20170718002947 MN Practitioner - Emergency Medicine 0244508240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-2164

927 Churchill W St
Stillwater, MN 55082-6605
Phone (651) 439-5330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61905MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2017 Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2017 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Regions Hospital CurrentSince Jul 1, 2017 Accepting new patients
Regions Hospital CurrentSince Jul 1, 2017 Accepting new patients
Regions Hospital Emergency Medicine Current Accepting new patients
Westfields Hospital, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Hudson Hospital, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Lakeview Memorial Hospital Association Inc CurrentSince Jul 1, 2017 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 30, 2025 Accepting new patients
Hudson Hospital, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Westfields Hospital, Inc CurrentSince Jul 1, 2017 Accepting new patients
Lakeview Memorial Hospital Association Inc. Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jan 12, 2026 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

640 Jackson St
#11102F
Saint Paul, MN 55101
Phone (651) 254-3456

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0308

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 12

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": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1689088387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 GRIFFIN ST E",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "540011439",
            "telephone_number": "715-268-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St # Mc11102F",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-5091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 Churchill St W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826605",
            "country_code": "US",
            "telephone_number": "651-439-5330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Stageline Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WI",
            "postal_code": "540171449",
            "country_code": "US",
            "telephone_number": "715-243-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "61905",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "67094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

Verify at the official NPI Registry.