Individual provider Active NPI

Allyson Christina Bagenholm, M.D.

  • Family Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1023279916
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME115466 Issued in FL
Practice address
3848 Fau Blvd Ste 305
Boca Raton, FL 33431-6437
Phone
(561) 430-3590
Fax
(561) 430-3590
NPI assigned
Jun 23, 2008
Last updated
Aug 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME115466 FL Primary
Family Medicine Physician 207Q00000X 051025 CT

Addresses

Primary practice location

3848 Fau Blvd Ste 305
Boca Raton, FL 33431-6437

Mailing address

3848 Fau Blvd Ste 305
Boca Raton, FL 33431-6437
Phone (561) 757-5530

Other practice location 1

1905 Clint Moore Rd Ste 202
Boca Raton, FL 33496-2660
Phone (561) 757-5530

Other identifiers 1

IdentifierTypeStateIssuer
1023279916OtherCTNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131203001359 FL Practitioner - Family PracticePractitioner - Emergency Medicine 1052580198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr B Medical PLLCGroup PAC ID 3577984038, 2 clinicians

Practice addresses (Care Compare)

3848 Fau Blvd
Suite 305
Boca Raton, FL 33431-6437
Phone (561) 757-5530

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051025CTMDFamily Medicine Physician
30699SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr B Medical PLLC Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Hartford Physician Services PC Family Medicine Past Accepting new patients
Complete Urgent Healthcare LLC PastSince Jun 2, 2019 Accepting new patients
Neophetos V Apostolopoulos MD PA PastSince Aug 1, 2020 Accepting new patients

Locations

1050 NW 15th St
Ste 107A
Boca Raton, FL 33486
Phone (561) 353-2061

1905 Clint Moore Rd
Ste 202
Boca Raton, FL 33496
Phone (561) 757-5530

3848 Fau Blvd
Ste 305
Boca Raton, FL 33431
Phone (305) 243-4530

Interoperability endpoints

  • Direct secure messaging: allyson.bagenholm.1@33410.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHBECD

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1023279916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 305",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-757-5530",
            "fax_number": "561-430-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 305",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-430-3590",
            "fax_number": "561-430-3590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 Clint Moore Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334962660",
            "country_code": "US",
            "telephone_number": "561-757-5530",
            "fax_number": "561-430-3590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGENHOLM",
        "first_name": "ALLYSON",
        "middle_name": "CHRISTINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME115466",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "051025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1023279916",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.