Samuel Yaw Boadu, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R 153044-3 Issued in MN

Practice address

409 North Dunlap Street
Open Cities Health Center
Saint Paul, MN 55104-4201

Phone

(651) 290-9200

Fax

(651) 290-9210

NPI assigned

Sep 13, 2006

Last updated

Jan 8, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Open Cities Health Center IncGroup PAC ID 5799696621, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.boadu@tdmc-mn.direct.office.nextgen.com

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.

• Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1225101405
  Medicare reassignment Care Compare group
• Odam Medical Group

  • Clinic/Center
  • Crystal, MN
  • NPI 1578934683
  Medicare reassignment NPD
• Odam Medical Group

  • Primary Care Clinic/Center
  • Foley, MN
  • NPI 1538059779
  NPD
• Odam Medical Group

  • Primary Care Clinic/Center
  • Saint Cloud, MN
  • NPI 1902392525
  NPD
• North Memorial Health Care

  dba North Memorial Health Specialty Clinic

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1871927715
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1063517100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 NORTH DUNLAP STREET",
            "address_2": "OPEN CITIES HEALTH CENTER",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 NORTH DUNLAP STREET",
            "address_2": "OPEN CITIES HEALTH CENTER",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044201",
            "telephone_number": "651-290-9200",
            "fax_number": "651-290-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOADU",
        "first_name": "SAMUEL",
        "middle_name": "YAW",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R 153044-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluesky Charter School
• Anna Roth Blumfield, LMFT
• Terri E Bly, PSYD, LP
• Stephen Blythe
• BNW L.L.C (Afya Therapy)
• Jessica Boarini, M.D.
• Sonja Minfay Boatman, MD
• Lisa Kay Boben, R.N.
• Kamil Bober
• Susan Jane Bobolink, LICSW

• Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.