Radha Magdaleen Boodram, ACUTE CARE NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4306021 Issued in NY

Practice address

1991 Marcus Ave
Suite 310
New Hyde Park, NY 11042-2057

Phone

(516) 472-6012

NPI assigned

Apr 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1083980296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "SUITE 310",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-472-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "address_2": "SUITE 310",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-472-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODRAM",
        "first_name": "RADHA",
        "middle_name": "MAGDALEEN",
        "credential": "ACUTE CARE NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "5107311",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "4306021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elias P Bonaros Jr., MD
• Richard Samuel Boneville, D.D.S.
• Anna Bongiorno, MA, CCC-SLP
• Jalen Bonitto
• Ryan Elizabeth Bonitz, PA-C
• Casandra Boomgarden, MD
• William C Boozan, MD
• Amy Lisa Borgen, PA
• Kylee Madison Borger, MD
• Binju Bose

• Acute Care Nurse Practitioner in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.