Nicole Bogue, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW21350 Issued in FL

Practice address

285 Clyde Morris Blvd Ste 300
Ormond Beach, FL 32174-8144

Phone

(386) 262-1627

Fax

(386) 262-1628

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

Yes

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 FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.43 of 100Reported as group

Quality

74.02

Promoting interoperability

100

Improvement activities

40

Cost

77.26

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.bogue.1@13142.direct.athenahealth.com

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.

• Dna Comprehensive Therapy Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757

  Clinical, FL

  Medicare reassignment Care Compare group NPD
• Bonita Springs Retirement Village, Inc.

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1902590847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-236-8784",
            "fax_number": "239-790-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 CLYDE MORRIS BLVD STE 300",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748144",
            "telephone_number": "386-262-1627",
            "fax_number": "386-262-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUE",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Journee Body
• Lauren Kaycie Boehm, LCSW
• Daniela Bogdanovska, PA-C
• Dragi Bogdanovski, D.O.
• Bogdanovski, PLLC
• Nicholas Bohan
• Richard Wayne Bolt III, PHARMD
• Julie Bom Conselho, ARNP
• Ramin D Bonnet, DO
• Louise Cox Booth, L.C.S.W

• All providers in Ormond Beach, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.