Individual provider Active NPI

Ryan David Boehm, M.D.

  • Interventional Cardiology Physician
  • Wakefield, RI
National Provider Identifier
1124342159
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD20203 Issued in RI
Practice address
70 Kenyon Ave
Wakefield, RI 02879-4239
Phone
(401) 789-5770
Fax
(401) 889-5082
NPI assigned
Mar 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD20203 RI Primary

Addresses

Primary practice location

70 Kenyon Ave
Wakefield, RI 02879-4239

Mailing address

455 Toll Gate Rd
PRC and Credentialing
Warwick, RI 02886-2759
Phone (401) 273-0641

Other practice location 1

100 Kenyon Ave
Wakefield, RI 02879-4216
Phone (401) 782-8000

Other practice location 2

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Other practice location 3

1405 South County Trail
Suite 1B
East Greenwich, RI 02818
Phone (401) 921-5411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190831000176 LA Practitioner - Interventional Cardiology 8022397595 Reassigns benefits to 2 organizations
I20241014004223 RI Practitioner - Interventional Cardiology 8022397595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC. 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kent County Memorial Hospital CurrentSince Dec 1, 2024 Accepting new patients
Affinity Physicians LLC. CurrentSince Dec 1, 2024 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Kent County Memorial Hospital CurrentSince Dec 1, 2024 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 15, 2022 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 15, 2022 Accepting new patients
Affinity Physicians LLC CurrentSince Dec 1, 2024 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2019 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 2019 Accepting new patients

Locations

1415 Tulane Ave
Fl 4
New Orleans, LA 70112
Phone (504) 988-5263

2820 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-4960

1430 Tulane Ave
#8648
New Orleans, LA 70112

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1514 Jefferson Hwy
New Orleans, LA 70121

3461 S County Trl
East Greenwich, RI 02818
Phone (401) 471-6740

1405 S County Trl
Ste 1B
East Greenwich, RI 02818
Phone (401) 921-5411

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

70 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

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 8

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": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1124342159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "address_2": "PRC AND CREDENTIALING",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 KENYON AVE",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794239",
            "telephone_number": "401-789-5770",
            "fax_number": "401-889-5082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Kenyon Ave",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794216",
            "country_code": "US",
            "telephone_number": "401-782-8000",
            "fax_number": "401-788-3830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 South County Trail",
            "address_2": "Suite 1B",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "02818",
            "country_code": "US",
            "telephone_number": "401-921-5411",
            "fax_number": "401-889-5082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "RI",
            "license": "MD20203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

Verify at the official NPI Registry.