Individual provider Active NPI

Mimi Bogart

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1740720200
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
725111 Issued in NY
Practice address
16 Sumner PL
Brooklyn, NY 11206-4110
Phone
(718) 336-9500
NPI assigned
Mar 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 725111 NY Primary

Addresses

Primary practice location

16 Sumner PL
Brooklyn, NY 11206-4110

Mailing address

16 Sumner PL
Brooklyn, NY 11206-4110
Phone (718) 336-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
725111NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1740720200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SUMNER PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064110",
            "telephone_number": "718-336-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SUMNER PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064110",
            "telephone_number": "718-336-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGART",
        "first_name": "MIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "725111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.