Erin Boumansour, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704311116 Issued in MI

Practice address

2366 Oak Valley Dr
Ann Arbor, MI 48103-8944

Phone

(877) 227-8823

NPI assigned

Dec 14, 2010

Last updated

Feb 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erin Ryan Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Northstar Palliative Care Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Ann Arbor, MI
  • NPI 1033638077
  Medicare reassignment

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1023311057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 OAK VALLEY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038944",
            "telephone_number": "877-227-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 OAK VALLEY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038944",
            "telephone_number": "877-227-8823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 E 88th St",
            "address_2": "#1D",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101286610",
            "country_code": "US",
            "telephone_number": "917-363-9529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUMANSOUR",
        "first_name": "ERIN",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430568",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704311116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "RYAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelsey Boudjalis
• Benjamin Boudreau, MD
• Jawad Bouhamdan
• Erin Valentine Boulger
• Matthew L Boulton, MD, MPH
• Rohman Bounds
• Elizaveta Bourchtein, PHD
• Dorothy Bourdet, M.D.
• Geraldine Bourlier, CNP
• Eileen Bourne

• Acute Care Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.