Individual provider Active NPI

Bozhena Tabakman, NP-C

  • Family Nurse Practitioner
  • Fort Stewart, GA
National Provider Identifier
1124109277
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
482505-1 Issued in NY
Practice address
1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5641
Phone
(912) 435-5353
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 482505-1 NY Primary

Addresses

Primary practice location

1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5641
Phone (912) 435-5353

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20191001002045 FL Practitioner - Nurse Practitioner 6103086160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Uniformed Services Uhs Fe Hebert School of Med, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey L Presser MD PAGroup PAC ID 4183894603, 5 clinicians

Practice addresses (Care Compare)

3385 Burns Rd
Suite 106
Palm Beach Gardens, FL 33410-4328
Phone (561) 691-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
482505-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey L Presser MD PA CurrentSince Jun 10, 2019 Accepting new patients

Locations

801 Meadows Rd
Ste 120
Boca Raton, FL 33486
Phone (561) 239-6494

3385 Burns Rd
Ste 106
Palm Beach Gardens, FL 33410
Phone (561) 691-0100

3385 Burns Rd
Ste 105
Palm Beach Gardens, FL 33410
Phone (561) 691-0100

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1124109277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABAKMAN",
        "first_name": "BOZHENA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "482505-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

Verify at the official NPI Registry.