Organization Active NPI

Aurum LLC

  • Gerontology Nurse Practitioner
  • Boise, ID
National Provider Identifier
1104705953
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
AURUM LLC
Practice address
11696 W Gabrielle CT
Boise, ID 83713-7812
Phone
(718) 362-1411
Fax
(718) 362-1651
NPI assigned
Aug 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Authorized official

Name
Sabrina Bojo, NPNPI 1194356022
Title
Owner
Phone
(718) 362-1411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X Primary

Addresses

Primary practice location

11696 W Gabrielle CT
Boise, ID 83713-7812

Mailing address

612 Corporate Way Ste 2M
Valley Cottage, NY 10989-2027
Phone (718) 362-1411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260525000544 ID Part B Supplier - Clinic/Group Practice 4880164474 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1104705953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 2M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "718-362-1411",
            "fax_number": "718-362-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11696 W GABRIELLE CT",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837137812",
            "telephone_number": "718-362-1411",
            "fax_number": "718-362-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "BOJO",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-362-1411",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.