Craig M Bogdanski, D.O.
Individual provider Active NPI Internal Medicine Physician · Southington, CT
NPI 1710986906 · NPPES record last updated Mar 24, 2009
Key facts
- NPI
- 1710986906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 039027 (CT)
- Practice address
- 825 Meriden Waterbury Tpke
Southington, CT 06489-4156 - Phone
- (860) 621-2673
- Fax
- (860) 621-2789
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bristol Hospital Multi Specialty Group, Inc.
Practice addresses (Care Compare)
167 Main St
Southington, CT 06489-2505
Phone (860) 426-0252
Hospital & facility affiliations
- Hartford Healthcare at Home
- Accentcare Hospice & Palliative Care of Conecticut
- Bristol Hospital
- The Hospital of Central Connecticut
- Griffin Hospital
- Yale-New Haven Hospital
- Southington Care Center
- Apple Rehab Farmington Valley
Merit-based Incentive Payment System (MIPS)
- Final score
- 54.86 of 100
- Quality
- 11.77
- Promoting interoperability
- 98
- Improvement activities
- 0
- Cost
- 73.13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090407000369 | CT | Practitioner - Internal Medicine | 4688738834 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039027 | CT | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bristol Hospital Multi Specialty Group, Inc | Internal Medicine | Current |
Accepting new patients |
Locations
41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000
167 Main St
Southington, CT 06489
Phone (860) 426-0252
Interoperability endpoints
- craig.bogdanski@bhmg.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 039027 | CT | Yes |
Addresses
Primary practice location
825 Meriden Waterbury Tpke
Southington, CT 06489-4156
Mailing address
365 Winding RDG
Southington, CT 06489-2180
Phone (860) 620-0801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001390278 | Medicaid | CT | |
| 040039027CT02 | Other | CT | BLUE CROSS/BLUE SHIELD |
Other providers in Southington, CT
- Arthur Blumer
- Margit Bobman
- Jessica Bocek
- Body Balance Therapeutic Massage
- Paige Bogda
- Sophia Bolio
- Kristin Bontempi
- Rachel L Booth
- Pamela Boushie
- Bradley Memorial Hospital and Health Center
All providers in Southington, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.