Active NPI
Bo Bao, M.D.
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1053170449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 75 Francis St
Boston, MA 02115 - Phone
- (587) 785-8651
- NPI assigned
- Mar 18, 2024
- Reactivated
- Feb 21, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
75 Francis St
Boston, MA 02115
Mailing address
11131 85 Ave NW
Unit 101
Edmonton, ALBERTA T6G0W7
CA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1053170449",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "11131 85 AVE NW",
"address_2": "UNIT 101",
"city": "EDMONTON",
"state": "ALBERTA",
"postal_code": "T6G0W7"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "587-785-8651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAO",
"first_name": "BO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-18",
"last_updated": "2025-02-21",
"deactivation_date": "2024-10-23",
"reactivation_date": "2025-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.