Mark T Boehnert, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

53723 Issued in MA

Practice address

133 Brookline Ave
Pediatrics Dept
Boston, MA 02215-3904

Phone

(617) 421-8888

Fax

(617) 421-8733

NPI assigned

Dec 15, 2005

Last updated

Oct 22, 2020By 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

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mboehnertmd3136@direct.atrius.masshiway.net

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.

• Atrius Health, Inc.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1871639914

  Pediatrics

  Medicare reassignment NPD
• Atrius Health, Inc.

  dba Harvard Vangard Medical Associates

  • Internal Medicine Physician
  • Needham, MA
  • NPI 1053862045
  NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Beverly, MA
  • NPI 1114265634
  NPD
• Atrius Health, Inc.

  dba Harvard Vanguard Medical Associates

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1740238526

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1083690614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-8888",
            "fax_number": "617-421-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "address_2": "PEDIATRICS DEPT",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-8888",
            "fax_number": "617-421-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHNERT",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "53723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3191231",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "PP319",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J10683",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0015141",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "053723",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboehnertmd3136@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "133 Brookline Ave",
            "address_2": "Pediatrics Dept",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "022153904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas Oliver Bodnar, MD, PHD
• Simon Christopher Body, MD
• Mackenzie Boedicker
• Aimee Kirsten Boegle, M.D.
• Martin John Boehm, P.T.
• Kris Marie Boelitz
• Paul Alfred Boepple, MD
• Elise Marie Westmeyer Boerjes, R.N.
• David Boerman, DMD
• Alana D Boermeester, PHARMD

• Pediatrics Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.