Individual provider Active NPI

Alexia Boumis

  • Adult Health Nurse Practitioner
  • Forest Hills, NY
National Provider Identifier
1053177394
Registry record updated Mar 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F311504-01 Issued in NY
Practice address
11835 Queens Blvd Ste 400
Forest Hills, NY 11375-7211
Phone
(646) 722-7610
NPI assigned
Feb 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F311504-01 NY Primary

Addresses

Primary practice location

11835 Queens Blvd Ste 400
Forest Hills, NY 11375-7211

Mailing address

PO Box 639295
Cincinnati, OH 45263-9295
Phone (248) 266-4200

Other practice location 1

118-35 Queens Blvd
Forest Hills, NY 11375
Phone (646) 722-7610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240403000688 NY Practitioner - Nurse Practitioner 9830537315 Reassigns benefits to 1 organization
I20250919000805 VA Practitioner - Nurse Practitioner 9830537315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-4123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F311504-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Harmony Medical Services of New York, PLLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

11835 Queens Blvd
Ste 400
Forest Hills, NY 11375
Phone (646) 722-7610

1802 Petracca Pl
Ste 103
Whitestone, NY 11357
Phone (646) 722-7610

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

2025 Glenn Mitchell Dr
Fl 4
Virginia Beach, VA 23456
Phone (757) 507-4103

Interoperability endpoints

  • Direct secure messaging: aboumis1073552@direct.sentara.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711152000000",
    "number": "1053177394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "248-266-4200",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD STE 400",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757211",
            "telephone_number": "646-722-7610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118-35 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "11375",
            "country_code": "US",
            "telephone_number": "646-722-7610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUMIS",
        "first_name": "ALEXIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-03-23",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311504-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.