Individual provider Active NPI

Benjamin Boese, LMSW

  • Social Worker
  • Saratoga Springs, NY
National Provider Identifier
1104490804
Registry record updated Mar 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112290 Issued in NY
Practice address
359 Ballston Ave
Saratoga Springs, NY 12866-4723
Phone
(518) 587-8008
NPI assigned
May 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 112290 NY Primary

Addresses

Primary practice location

359 Ballston Ave
Saratoga Springs, NY 12866-4723

Mailing address

359 Ballston Ave
Saratoga Springs, NY 12866-4723
Phone (518) 587-8008

Other practice location 1

530 Franklin St
Schenectady, NY 12305-2008
Phone (518) 426-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
112290NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1104490804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 BALLSTON AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664723",
            "telephone_number": "518-587-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 BALLSTON AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664723",
            "telephone_number": "518-587-8008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123052008",
            "country_code": "US",
            "telephone_number": "518-426-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOESE",
        "first_name": "BENJAMIN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.