Dmitry Bogomolny, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

013776-1 Issued in NY

Practice address

635 W 165TH St
New York, NY 10032-3724

Phone

(212) 305-3015

NPI assigned

Feb 6, 2010

Last updated

Apr 25, 2017By 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

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: dmb2008@direct.nyp.org
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD (past)
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488

  Physician Assistant

  NPD
• Trustees of Columbia University in the Department of Otolaryngology

  • Specialist
  • New York, NY
  • NPI 1801074315
  NPD (past)

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

{
    "created_epoch": "1265414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1891027405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST",
            "address_2": "BOX 435",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "212-305-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "212-305-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOMOLNY",
        "first_name": "DMITRY",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-06",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013776-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liora Bogin
• Jennifer Lee Bogle, LCSW
• Mary T Bogle, PT, DPT
• Eric Bogner, M.D.
• Alexander Bognot, PA
• Lauren Cochran Bogorad, LMSW
• Jarrod Terrence Bogue, MD
• Kevin Bogue, NURSE PRACTITIONER
• Magdalena M Bogun, MD
• Lisa Boguski-Filgueira, M.D.

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.