Boris V Bogomilov, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

E4311 Issued in AR

Practice address

3211 N Northhills Blvd
Suite 110
Fayetteville, AR 72703-4007

Phone

(479) 571-4338

Fax

(479) 571-4015

NPI assigned

Apr 17, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
• North Arkansas Regional Medical Center Hospital, Harrison, AR, CCN 040017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbogomilov@walkerheart.gwaydirect.com
• Direct secure messaging: bbogomilov21340@washingtonregional.direct-ci.com

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.

• Washington Regional Medical System

  dba Walker Heart Institute Cardiovascular Clinic

  • Interventional Cardiology Physician
  • Fayetteville, AR
  • NPI 1679890966
  Medicare reassignment Care Compare group NPD
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Farmington

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD
• Northwest Arkansas Heart & Vascular Center

  • Interventional Cardiology Physician
  • Fayetteville, AR
  • NPI 1982648663
  NPD (past)
• Washington Regional Medical System

  dba Washington Regional Hospital Medicine Group

  • Hospitalist Physician
  • Fayetteville, AR
  • NPI 1306801485
  NPD (past)
• Cardiology of Tulsa Inc. Dba Cardiology Diagnostics of Tulsa

  • Cardiovascular Disease Physician
  • Tulsa, OK
  • NPI 1255528956
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Rogers

  dba Mercy Hospital Northwest Arkansas

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation
• North Arkansas Regional Medical Center

  dba Emergency Medical Service Pro Fee

  • Land Ambulance
  • Harrison, AR
  • NPI 1013907682

  Hospital

  Care Compare affiliation
• North Arkansas Regional Medical Center

  • General Acute Care Hospital
  • Harrison, AR
  • NPI 1275523912
  Care Compare affiliation
• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1790749638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 N NORTHHILLS BLVD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034007",
            "telephone_number": "479-571-4338",
            "fax_number": "479-571-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOMILOV",
        "first_name": "BORIS",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "AR",
            "license": "E4311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207453101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7934401",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200005240A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "5020011800",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E4311",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156638001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bluebird Health PLLC
• Christopher Anthony Blum, DO
• Benjamin D Boatwright, BS, QBHP
• Body Mechanix LLC
• Boeckmann Behavioral Services LLC
• Stephanie L Bohannon, PMHNP, APRN
• Hannah Elizabeth Bohl, PT, DPT
• Bold Dental Partners PLLC
• Michael A Bolding, D.O.
• Taruna Sharma Bolding, D.D.S.

• Clinical Cardiac Electrophysiology Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Cardiac Electrophysiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.