Individual provider Active NPI

Branko Bojovic, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Baltimore, MD
National Provider Identifier
1689874398
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
D72525 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6704
Fax
(410) 328-4124
NPI assigned
Jul 20, 2007
Last updated
May 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 221840 MA
Plastic and Reconstructive Surgery Physician 2086S0122X D72525 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64793
Baltimore, MD 21264-4793
Phone (410) 328-6704

Other identifiers 2

IdentifierTypeStateIssuer
420596100MedicaidMD
0142OtherMDBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20151027002113 MA Practitioner - Plastic and Reconstructive Surgery 0941478796 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
State University of New York at Buffalo School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221840MAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 9, 2015 Accepting new patients
The Shriners' Hospital for Children Current Accepting new patients
The Shriners' Hospital for Children CurrentSince Mar 18, 2020 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Oct 9, 2015 Accepting new patients
The Shriners' Hospital for Children CurrentSince Mar 18, 2020 Accepting new patients
The Shriners' Hospital for Children Past Accepting new patients

Locations

15 Parkman St
Boston, MA 02114
Phone (617) 726-3023

15 Parkman St
#435
Boston, MA 02114
Phone (617) 726-8554

51 Blossom St
Boston, MA 02114
Phone (617) 371-4762

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

516 Carew St
Springfield, MA 01104
Phone (413) 787-2000

Interoperability endpoints

  • Direct secure messaging: bojovic.branko.mgh@direct.partners.masshiway.net

Organizations & group practices 7

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 1

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1689874398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64793",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644793",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOJOVIC",
        "first_name": "BRANKO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "221840",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MD",
            "license": "D72525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420596100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0142",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.