Physician Compare National (NPI:1861438004)

HEALTHCARE PROVIDER: THOMAS PAUL BOGAARD MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1861438004
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961470794
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051222000703
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOGAARD
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1245 WILSHIRE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 306
	Group Practice or individual's line 2 address
City	LOS ANGELES
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	900174803
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050149
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CALIFORNIA HOSPITAL MEDICAL CENTER LA
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y