NPIMap

Individual provider Active NPI

Craig M Bogdanski, D.O.

  • Internal Medicine Physician
  • Southington, CT
National Provider Identifier
1710986906
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
039027 Issued in CT
Practice address
825 Meriden Waterbury Tpke
Southington, CT 06489-4156
Phone
(860) 621-2673
Fax
(860) 621-2789
NPI assigned
Jul 19, 2005
Last updated
Mar 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 039027 CT Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090407000369 CT Practitioner - Internal Medicine 4688738834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

167 Main St
Southington, CT 06489-2505
Phone (860) 426-0252

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.86 of 100Reported as group
Quality
11.77
Promoting interoperability
98
Improvement activities
0
Cost
73.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039027CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Multi Specialty Group, Inc Internal Medicine CurrentSince Oct 2, 2023 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

  • Direct secure messaging: craig.bogdanski@bhmg.eclinicaldirectplus.com

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 10

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1710986906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 WINDING RDG",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892180",
            "telephone_number": "860-620-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 MERIDEN WATERBURY TPKE",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064894156",
            "telephone_number": "860-621-2673",
            "fax_number": "860-621-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDANSKI",
        "first_name": "CRAIG",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "039027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.