Kathleen Boczar, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP000980B Issued in PA

Practice address

1900 N 9TH St
Suite 104
Philadelphia, PA 19122-1909

Phone

(215) 765-6690

Fax

(215) 765-6694

NPI assigned

Jun 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleenboczar@nncc.allscriptsdirect.net

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.

• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881779866
  Medicare reassignment NPD
• Public Health Management Corp

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1295873461
  NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1467776989
  NPD

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1164464798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET STREET",
            "address_2": "LM 500 WEST TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202100",
            "telephone_number": "215-985-2595",
            "fax_number": "215-765-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N 9TH ST",
            "address_2": "SUITE 104",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191221909",
            "telephone_number": "215-765-6690",
            "fax_number": "215-765-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCZAR",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP000980B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1487818",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2268271000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1590263",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018132210001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO",
            "identifier": "16605",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY HEALTH PLAN",
            "identifier": "30027018",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Bocchese
• Nancy L Bocchino, CRNP
• Boccia Holding Company
• Angela Boccuti, CRNP
• Melissa Ann Boctor
• Kevin Emery Boczar, MD
• Christopher Scott Bodden, MD
• Raja Srinivas Boddepalli
• Michael Friedrich Johannes Bode, M.D.
• Matthew Gafni Boden, MD

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.