Individual provider Active NPI

Douglas Bogdanoff, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1982082889
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018607 Issued in PA
Practice address
3535 Market St
3Rd Floor
Philadelphia, PA 19104-3309
Phone
(215) 746-6700
NPI assigned
May 12, 2015
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW018607 PA Primary

Addresses

Primary practice location

3535 Market St
3Rd Floor
Philadelphia, PA 19104-3309

Mailing address

3535 Market St
3Rd Floor
Philadelphia, PA 19104-3309
Phone (215) 746-6700

Other identifiers 1

IdentifierTypeStateIssuer
082178OtherNYNY STATE LCSW LICENSE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20161219002050 PA Practitioner - Clinical Social Worker 9537440144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3535 Market St
FL 3
Philadelphia, PA 19104-3317
Phone (215) 746-6700

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW018607PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Clinical CurrentSince Nov 22, 2016 Accepting new patients
University of Penn-Medical Group CurrentSince Nov 22, 2016 Accepting new patients

Locations

3535 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 746-6700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1982082889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043309",
            "telephone_number": "215-746-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043309",
            "telephone_number": "215-746-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDANOFF",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LCSW LICENSE",
            "identifier": "082178",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.