Mina Boazak, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2019-00873 Issued in NC

Practice address

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102

Phone

(919) 391-7202

Fax

(919) 391-7203

NPI assigned

Jul 7, 2015

Last updated

Jan 14, 2026By 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 NC, GA, AR, OK, WA, MO, NY, AZ8 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 8

Specialty

Psychiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Animo Sano Psychiatry PLLCGroup PAC ID 8729489182, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: animosanopsychiatry.minaboazak@149583.advancedmd-direct.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.

• Animo Sano Psychiatry PLLC

  • Psychiatry Physician
  • Durham, NC
  • NPI 1568043537

  AR, AZ, GA, MO, NY, OK, WA

  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1104209329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 NE McClain Rd Bldg 7",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727123875",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 S 4th St Ste 550",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631021800",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "64 E Broadway Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852821377",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 Clinton Sq Ofc 509",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146041700",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 5th Ave Ofc 1080",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981013621",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Robert S Kerr Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731024203",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "fax_number": "919-391-7203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOAZAK",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2019-00873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Evan Joseph Bockover, PT, DPT

• Psychiatry Physician in Durham, NC
• Providers in Durham, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.