DR. EDWIN NDEMO BOGONKO (MD) – Internal Medicine Physician, NPI 1447444666

DR. EDWIN NDEMO BOGONKO (MD) is a healthcare provider. based in Shakopee, Minnesota. specializing in INTERNAL MEDICINE. They hold the professional credentials MD. They hold a License No. 50217 (MN). The NPI Number for DR. EDWIN NDEMO BOGONKO (MD) is 1447444666

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. EDWIN NDEMO BOGONKO (MD)
NPI
1447444666
Phone
(952) 403-3535
Address
1515 SAINT FRANCIS AVE
Enumeration Date
30 August 2007
Last Update Date
16 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1994 (32 years ago)
PAC ID
7416045000
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20071115000202
Address ID
MN553131947BU303XXSTXX300
Telehealth
Yes

Contacts

Secure Messaging
ebogonko66673@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness85
Years active:18State licenses:1Other namesUpdated within 12 months

3,638 INTERNAL MEDICINE in MN

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Provider Addresses for DR. EDWIN NDEMO BOGONKO (MD)

  • 1515, Saint Francis Avenue, Shakopee, Scott County, Minnesota, 55379, United States

    SUITE # 100

    SHAKOPEE, MN 553793387

    Phone: (952) 403-3535

    Fax: (952) 403-3599

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $122.

Total Amount is formed as General ($122) + Research ($0) + Ownership ($0) = $122.

Last reported payment date: 2024-10-30 • Largest payer in this snapshot: Gilead Sciences, Inc. ($122).

Total Amount

$122

General + Research + Ownership

Payments

1

Total payment records

General Amount

$122

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Gilead Sciences, Inc.$122
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-10-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071115000202IInternal MedicineMNTBD
I20191003001275IInternal MedicineWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes355210$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes350227$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes269261$0
99239Hospital discharge day management, more than 30 minutes120116$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes7676$0
View full utilization report →

Insurance plans in this area (ZIP 55379)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587573613View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. EDWIN NDEMO BOGONKO (MD)?
DR. EDWIN NDEMO BOGONKO (MD) — NPI 1447444666 — is the standard way to identify this listing.
Can I rely on DR. EDWIN NDEMO BOGONKO (MD) being an active provider?
As of the registry snapshot, DR. EDWIN NDEMO BOGONKO (MD) is marked active.
What is DR. EDWIN NDEMO BOGONKO (MD)'s specialty?
The listing groups DR. EDWIN NDEMO BOGONKO (MD) with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. EDWIN NDEMO BOGONKO (MD) based?
DR. EDWIN NDEMO BOGONKO (MD) is tied to Shakopee, Minnesota in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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