Tanya Boldenow

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301088387 Issued in MI

Practice address

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

Phone

(734) 712-3935

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Pediatric MedicineAlso: Emergency Medicine, Internal Medicine

Education

Wayne State University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Epmg of Michigan, P.C.

  • Emergency Medicine Physician
  • Livonia, MI
  • NPI 1386688992
  Medicare reassignment NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  dba IHA Infectious Diseases Consultants

  • Infectious Disease Physician
  • Ypsilanti, MI
  • NPI 1639423825
  NPD
• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1083837173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-712-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDENOW",
        "first_name": "TANYA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301088387",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301088387",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301099387",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301088387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joelle Wilson Boeve, M.D.
• David Boeving
• Ronald S Bogdasarian, MD
• Erin Boggs
• Ann Richards Bogits, OTR/L
• Nelly Lokwa Bolenge
• Brianna Boley
• Rachel Evette Bolin, OTR/L
• Ashley Boller, PA-C
• Toni Marie Bologna, CRNA

• Internal Medicine Physician in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.
• 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.