Individual provider Active NPI

Kwaku Osafo-Mensah Boamah, MD

  • Obstetrics & Gynecology Physician
  • Jersey City, NJ
National Provider Identifier
1154413029
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MA64482 Issued in NJ
Practice address
1921 Kennedy Blvd
Jersey City, NJ 07305-2117
Phone
(201) 333-8800
Fax
(201) 333-8585
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA64482 NJ Primary

Addresses

Primary practice location

1921 Kennedy Blvd
Jersey City, NJ 07305-2117

Mailing address

1921 Kennedy Blvd
Jersey City, NJ 07305-2117
Phone (201) 333-8800

Other identifiers 1

IdentifierTypeStateIssuer
7901003MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20121127000332 NJ Practitioner - Obstetrics/Gynecology 4789645862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

317 Central Ave
Jersey City, NJ 07307-2915
Phone (201) 984-1270

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Bachelor of Science, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA64482NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Nov 1, 2020 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 1, 2020 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Jun 10, 2019 Accepting new patients
Jersey City Medical Center Past Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

142 Palisade Ave
Ste 200
Jersey City, NJ 07306
Phone (201) 435-2244

150 Warren St
Jersey City, NJ 07302
Phone (201) 309-3000

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

317 Central Ave
Jersey City, NJ 07307
Phone (201) 839-2640

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

Interoperability endpoints

  • Direct secure messaging: kboamah45813@epicdirect.rwjbh.org

Organizations & group practices 4

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154413029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052117",
            "telephone_number": "201-333-8800",
            "fax_number": "201-333-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052117",
            "telephone_number": "201-333-8800",
            "fax_number": "201-333-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAMAH",
        "first_name": "KWAKU",
        "middle_name": "OSAFO-MENSAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA64482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.