Dustin W Bogan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110005643 Issued in VA

Practice address

1204 W Main St
Charlottesville, VA 22903-2824

Phone

(434) 924-8184

NPI assigned

Jan 5, 2017

Sex

Male

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 VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment
• Pediatric & Adolescent Health Partners, P.C.

  • Pediatrics Physician
  • Midlothian, VA
  • NPI 1851458178
  NPD (past)

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1790220341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W MAIN ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032824",
            "telephone_number": "434-924-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24560 Southpoint Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Aldie",
            "state": "VA",
            "postal_code": "201053505",
            "country_code": "US",
            "telephone_number": "571-248-7472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13821 Village Mill Dr",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231144314",
            "country_code": "US",
            "telephone_number": "804-794-2821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "DUSTIN",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-05",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110005643",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah G Bodin, MD
• Stephan Bodkin, MED, ATC
• Carol A Boersma, M.D.
• Marissa Boettcher, MD
• Joseph Daniel Bogaard, MD, PHD
• Brennan Steele Bogdanovich
• Zachary Boggs, MD
• Sara Dogom Bohon, MD
• Amy D Boitnott, FNP, PNP
• Eric Bokinsky

• Physician Assistant in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.