Mario Bovino, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

125.078044 Issued in IL

Practice address

650 Richard Gordon Hatcher Blvd
Gary, IN 46404-1533

Phone

(219) 738-4926

Fax

(219) 738-4931

NPI assigned

Jul 15, 2021

Last updated

Jul 29, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1861064131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 RICHARD GORDON HATCHER BLVD",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464041533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 RICHARD GORDON HATCHER BLVD",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464041533",
            "telephone_number": "219-738-4926",
            "fax_number": "219-738-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVINO",
        "first_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.078044",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125.078044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Scott Bodkin, D.O.
• Ryan J. Boilek, PTA
• Alyncia Bonner
• Camille A Borders, M.D.
• Shirley Borom, R.N.
• Lechristien Renee Box, MA
• Khawanda Kim Boyd, PBT
• Rahnaysha Diane Boyd
• Darius Brannon, B.A., CADAC II
• Sylvia Brantley

• Neurology Physician in Gary, IN
• Providers in Gary, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.