Individual provider Active NPI

Renee Fine Bogomolny, D.C.

  • Chiropractor
  • Santa Monica, CA
National Provider Identifier
1891181673
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33231 Issued in CA
Practice address
2812 Santa Monica Blvd
Suite 208
Santa Monica, CA 90404-2476
Phone
(310) 488-7277
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33231 CA Primary

Addresses

Primary practice location

2812 Santa Monica Blvd
Suite 208
Santa Monica, CA 90404-2476

Mailing address

4624 Maleza PL
Tarzana, CA 91356-4721
Phone (310) 844-5502

Other names 1

  • Renee Jane Fine Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150523000015 CA Practitioner - Chiropractic 0244550390 Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2812 Santa Monica Blvd
Suite 208
Santa Monica, CA 90404-2432
Phone (310) 844-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33231CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
A Fine Spine Chiropractic, a Bogomolny Corp. Chiropractor CurrentSince Jan 19, 2025 Accepting new patients

Locations

2812 Santa Monica Blvd
Ste 208
Santa Monica, CA 90404
Phone (310) 447-1862

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1891181673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 MALEZA PL",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564721",
            "telephone_number": "310-844-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 SANTA MONICA BLVD",
            "address_2": "SUITE 208",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042476",
            "telephone_number": "310-488-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOMOLNY",
        "first_name": "RENEE",
        "middle_name": "FINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "FINE",
            "middle_name": "JANE",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.