Boonyong P Thada, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0019823 Issued in MD

Practice address

5356 Reisterstown Road
Baltimore, MD 21215-4493

Phone

(410) 358-5111

Fax

(410) 358-9169

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Boonyong Phruithithada Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saluja Medical Associates

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1932399466
  Medicare reassignment NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033218060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5356 REISTERSTOWN ROAD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212154493",
            "telephone_number": "410-358-5111",
            "fax_number": "410-358-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5356 REISTERSTOWN ROAD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212154493",
            "telephone_number": "410-358-5111",
            "fax_number": "410-358-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THADA",
        "first_name": "BOONYONG",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0019823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOONYONG",
            "last_name": "PHRUITHITHADA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Selam Tewolde, M.D.
• John Henry Texter, PA-C
• Oleg Moisey Teytelboym, MD
• TG Consulting Services
• Daniel Ryan Thacker, RRT-ACCS
• Ashley Thai
• Christine Hong Ngoc Thai, MD
• Ting T Thai
• Falak Thaker
• Aarti Maitreya Thakkar, MD, MPH

• Internal Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.