Lola C. Bogyo, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS1251 Issued in ME

Practice address

277 State St
Suite 2a
Bangor, ME 04401-5439

Phone

(207) 990-2580

Fax

(207) 990-1930

NPI assigned

Apr 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Perelman School of Med at the University of Pennsylvania, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neuropsychology Service PAGroup PAC ID 6608896709, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Neuropsychology Service PA

  • Clinical Psychologist
  • Bangor, ME
  • NPI 1811100068
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1689891384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 STATE ST",
            "address_2": "SUITE 2A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015439",
            "telephone_number": "207-990-2580",
            "fax_number": "207-990-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 STATE ST",
            "address_2": "SUITE 2A",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015439",
            "telephone_number": "207-990-2580",
            "fax_number": "207-990-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGYO",
        "first_name": "LOLA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ME",
            "license": "PS1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1689891384",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Retha K. Bobb, PNP
• Mahdieh Bodaghi, M.D.
• Sherry M Bodge, LD
• Katherine Ann Bodkin, LCSW
• Ronald Nicholas Bogdasarian, MD
• Penny Bohac-Cardello, LCPC
• Nicholas Boissoneault, PT
• Lynn M Bolduc, MS, RD,LD,CDE
• Reilly Autumn Bolin, FNP
• Elizabeth Bollenbacher, DO

• Clinical Neuropsychologist in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Neuropsychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.