Jennifer Kim Bogan, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

29223 Issued in AZ

Practice address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Phone

(952) 595-1301

Fax

(612) 294-4903

NPI assigned

Jan 26, 2006

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

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.

• Integrated Imaging Consultants LLC

  • Diagnostic Radiology Physician
  • Park Ridge, IL
  • NPI 1700285335

  AZ

  Medicare reassignment NPD
• Mori Bean and Brooks Inc

  dba Coastal Vein Vascular Institute

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070

  AZ

  Medicare reassignment NPD
• Radiology Associates of South Florida LLC

  • Diagnostic Radiology Physician
  • Longview, TX
  • NPI 1699759183

  AZ

  Medicare reassignment NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology

  Medicare reassignment NPD
• Ton San Simon Health Center

  dba San Simon Health Center

  • Health Service Clinic/Center
  • Sells, AZ
  • NPI 1588834998

  TX

  Medicare reassignment NPD
• Ton San Xavier Health Center

  dba San Xavier Health Center

  • Federal Public Health Clinic/Center
  • Tucson, AZ
  • NPI 1437157302

  TX

  Medicare reassignment NPD
• Ton Sells Hospital

  dba Sells Hospital

  • Public Health or Welfare Agency
  • Sells, AZ
  • NPI 1487652426

  TX

  Medicare reassignment NPD
• Radiological Group, PA

  • Specialist
  • Jackson, MS
  • NPI 1346398625
  NPD (past)
• RLC LLC

  dba Radiology Ltd. - Carondelet

  • Diagnostic Radiology Physician
  • Tucson, AZ
  • NPI 1528224904
  NPD (past)
• Ton San Xavier Health Center

  dba Ton San Xavier Health Center Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Tucson, AZ
  • NPI 1518905793
  NPD (past)
• Ton Sells Hospital

  dba Ton Sells Hospital Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Sells, AZ
  • NPI 1699717785
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1720058001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "JENNIFER",
        "middle_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME125290",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "29223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eve R. Boaheng, HIS
• Stewart Eric Bober, MD
• Ann Bodensteiner, MA LP
• Jennifer Joan Bodmer, PHARMD
• Alissa Boekhout, NP
• Nina Anne Boguslawski
• Trang C Bohannon
• Amanda Boldt
• Stephen Bolles, DC
• Nancy Claire Bologna, PHD, MS, LP

• Diagnostic Radiology Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.