Individual provider Active NPI

Brian Edward Boden, D.O.

  • Internal Medicine Physician
  • Abington, PA
National Provider Identifier
1134651250
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
304138 Issued in NY
Practice address
1200 Old York Rd Ste 2B
Abington, PA 19001-3720
Phone
(215) 481-2000
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 304138 NY Primary

Addresses

Primary practice location

1200 Old York Rd Ste 2B
Abington, PA 19001-3720

Mailing address

240 Meeting House Lane
Southampton, NY 11968
Phone (631) 726-8200

Other practice location 1

201 Manor Place
Greenport, NY 11944
Phone (631) 726-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200604000497 NY Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Hospitalist 0446671184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 986-3308

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Sep 9, 2025 Accepting new patients
Meeting House Lane Medical Practice PC Internal Medicine CurrentSince Jul 7, 2020 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

240 Meeting House Ln
Southampton, NY 11968
Phone (631) 726-0409

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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 2

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1134651250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MEETING HOUSE LANE",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-726-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD YORK RD STE 2B",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013720",
            "telephone_number": "215-481-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Manor Place",
            "address_purpose": "LOCATION",
            "city": "Greenport",
            "state": "NY",
            "postal_code": "11944",
            "country_code": "US",
            "telephone_number": "631-726-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODEN",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "304138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, PA

Sources for this page

Verify at the official NPI Registry.