Tyler Ross Bogus, DO
Emergency Medicine in Brandon, FL. Individual provider (NPI-1).
NPI number1740817014
StatusActive
Last updated in NPPESJun 27, 2024
Details
- NPI
- 1740817014
- Entity type
- Individual (NPI-1)
- Name
- Tyler Ross Bogus
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2020
- Certification date
- Jun 27, 2024
- Last updated
- Jun 27, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - EMERGENCY MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | OS19206 | FL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
119 Oakfield DrBrandon, FL 33511-5779
Phone 813-916-2347
Mailing address
119 Oakfield DrBrandon, FL 33511-5779
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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