KISHANRAO BOGAVELLI (NPI# 1538371745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538371745 |
| Entity Type | Individual |
| Full Name | KISHANRAO BOGAVELLI |
| Credential | MD |
| Practice Address |
680 Broadway Paterson NJ 07514-1422 |
| Mailing Address |
484 Temple Hill Rd Ste 102 New Windsor NY 12553-5557 |
| Practice Telephone | 9739776603 |
| Mailing Telephone | 8455653700 |
| Mailing Fax Number | 8455653395 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MA44068 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 3721205 | 05 |
| Street Address |
680 BROADWAY |
| City | PATERSON |
| State | NJ |
| Zip Code | 07514-1422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112115 | Joseph Albert Pena | Specialist | 680 Broadway, Barnert Hospital Anesthesia Dept, Paterson, NJ 07514-1422 | 2005-05-23 |
| 1417459496 | Advanced Rehabilitation Medicine, PC | Physical Medicine & Rehabilitation | 680 Broadway, Paterson, NJ 07514-1524 | 2018-03-06 |
| 1134635311 | Kathleen Meehan-hart | Midwife | 680 Broadway, Paterson, NJ 07514-1524 | 2017-12-24 |
| 1750816492 | Kimberly Zurla | Audiologist | 680 Broadway, Paterson, NJ 07514-1524 | 2017-05-01 |
| 1710368576 | Barnert Imaging LLC | Clinic/Center | 680 Broadway, Suite 008, Paterson, NJ 07514 | 2015-06-17 |
| 1740678861 | Freehold Healthcare, LLC | Clinic/Center | 680 Broadway, Suite 601, Paterson, NJ 07514-1524 | 2014-12-23 |
| 1134523632 | Turning Point Inc | Clinic/Center | 680 Broadway, Suite 104, Paterson, NJ 07514-1524 | 2014-10-14 |
| 1629479753 | Martina S. Murphy | Nurse Practitioner | 680 Broadway, Paterson, NJ 07514-1524 | 2014-09-08 |
| 1578962916 | Blue River Women's Health Pa | Specialist | 680 Broadway, Ste 506 First Floor, Paterson, NJ 07514-1524 | 2014-08-21 |
| 1669881975 | Paterson Medical Health Services Corporation | Clinic/Center | 680 Broadway, Suite 101, Paterson, NJ 07514-1524 | 2014-08-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396996724 | Durable Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 750 Broadway 1st Floor Suite F, Paterson, NJ 07514 | 2008-10-03 |
| 1649387762 | Gurmit S Chilana | Obstetrics & Gynecology | 695 Broadway, Paterson, NJ 07514 | 2006-08-24 |
| 1396859385 | Mahesh M Mehta | General Practice | 426 10th Ave, Paterson, NJ 07514 | 2006-08-18 |
| 1780649608 | Ashoke Agarwal | Internal Medicine | 715 Broadway, Ste 1, Paterson, NJ 07514 | 2006-04-20 |
| 1750342762 | David Leonard Fink | Surgery | 707 Broadway, Paterson, NJ 07514 | 2006-03-29 |
| 1720049091 | Qing Lin | Pathology | 680 Martin Luther King Jr Way, Patterson, NJ 07514 | 2006-03-28 |
| 1720049166 | Pathology Services, LLC | Specialist | 680 Martin Luther King Jr. Way, Patterson, NJ 07514 | 2006-03-28 |
| 1013524065 | Nj Vein Clinics | Clinic/Center | 583 Broadway, Paterson, NJ 07514 | 2020-09-24 |
| 1134645450 | Esther Faye Feinstein | Physician Assistant | 660 Broadway, Paterson, NJ 07514 | 2017-08-17 |
| 1134591795 | Smile Cares Family Dentistry | Dentist | 715 Broadway, Suite #201, Patterson, NJ 07514 | 2015-10-22 |
| Find all providers in zip 07514 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447541768 | Eric Steinberg | Emergency Medicine | 703 Main St # 703, Paterson, NJ 07503-2621 | 2011-04-20 |
| 1457593196 | Coral Diagnostics, LLC | Emergency Medicine | 684 Market St, Paterson, NJ 07513-1231 | 2009-03-26 |
| 1669588422 | Fred Revoredo | Emergency Medicine | 425 15th Ave, Paterson, NJ 07504-1811 | 2006-08-22 |
| 1568982957 | Raymond B Isenburg | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2017-06-27 |
| 1760833735 | Navtarunjot Singh | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2016-06-30 |
| 1679924773 | Hima Khamar | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2016-06-29 |
| 1215388525 | Nicholas Mota | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2016-06-28 |
| 1417308859 | Kerri Clayton | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2016-06-27 |
| 1215313812 | Katrina D'amore | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2015-08-05 |
| 1578947420 | Yenisleidy Paez Perez | Emergency Medicine | 703 Main St, Paterson, NJ 07503-2621 | 2015-07-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.