Individual provider Active NPI

Imene Boumaza, M.D

  • Critical Care Medicine (Internal Medicine) Physician
  • Amarillo, TX
National Provider Identifier
1093109993
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
U9714 Issued in TX
Practice address
6700 W 9TH Ave
Amarillo, TX 79106-1701
Phone
(806) 358-0200
Fax
(806) 356-5590
NPI assigned
Mar 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 88108 SC
Pulmonary Disease Physician 207RP1001X U9714 TX
Student in an Organized Health Care Education/Training Program 390200000X
Critical Care Medicine (Internal Medicine) Physician 207RC0200X U9714 TX Primary

Addresses

Primary practice location

6700 W 9TH Ave
Amarillo, TX 79106-1701

Mailing address

6700 W 9TH Ave
Amarillo, TX 79106-1701
Phone (806) 358-0200

Other practice location 1

125 Professional Park Dr
Seneca, SC 29678-2558
Phone (864) 482-3000

Other practice location 2

506 6th St
Brooklyn, NY 11215-3609
Phone (718) 780-3000

Other practice location 3

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Other practice location 4

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220915002358 SC Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8325423080 Reassigns benefits to 3 organizations
I20240822004521 TX Practitioner - Pulmonary Disease 8325423080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians
Bsa Amarillo Diagnostic Clinic IncGroup PAC ID 5294959433, 31 clinicians

Practice addresses (Care Compare)

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

6700 SW 9TH Ave
Amarillo, TX 79106-1701
Phone (806) 358-0200

Hospital & facility affiliations

  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88108SCMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Aug 1, 2022 Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 18, 2024 Accepting new patients
Bsa Amarillo Diagnostic Clinic Inc CurrentSince Dec 1, 2024 Accepting new patients
Musc Community Physicians Pulmonary Disease CurrentSince Jun 15, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Critical Care Medicine CurrentSince Aug 1, 2022 Accepting new patients
Musc Community Physicians CurrentSince Jun 15, 2024 Accepting new patients
Bsa Physicians Group Inc CurrentSince Sep 1, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 18, 2024 Accepting new patients
Bsa Physicians Group Inc CurrentSince Sep 1, 2024 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

125 Professional Park Dr
Seneca, SC 29678
Phone (864) 482-3000

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

6700 W 9th Ave
Amarillo, TX 79106
Phone (806) 358-0200

Interoperability endpoints

  • Direct secure messaging: iboumaza474369@direct.musc.edu
  • Direct secure messaging: iboumaza23386@directmcleodehealth.org
  • Direct secure messaging: iboumaza822840@direct.ghs.myhfn.org
  • Direct secure messaging: iboumaza962450@ahs.direct-ci.com

Organizations & group practices 9

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": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1093109993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061701",
            "telephone_number": "806-358-0200",
            "fax_number": "806-356-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061701",
            "telephone_number": "806-358-0200",
            "fax_number": "806-356-5590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296782558",
            "country_code": "US",
            "telephone_number": "864-482-3000",
            "fax_number": "864-482-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 E Cheves St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295062617",
            "country_code": "US",
            "telephone_number": "843-777-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Wallace Blvd",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061799",
            "country_code": "US",
            "telephone_number": "806-212-2129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUMAZA",
        "first_name": "IMENE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-28",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "88108",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "U9714",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "U9714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.