Individual provider Active NPI

Millicent Akosua Boahemaa, F.N.P

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1164718359
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F335757-1 Issued in NY
Practice address
2544 8TH Ave Apt 4B
New York, NY 10030-2454
Phone
(212) 926-3498
NPI assigned
Jun 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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 F335757-1 NY Primary

Addresses

Primary practice location

2544 8TH Ave Apt 4B
New York, NY 10030-2454

Mailing address

460 W 34TH St
New York, NY 10001-2382
Phone (212) 926-3498

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330001984 NY Practitioner - Nurse Practitioner 8628207347 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F335757-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. CurrentSince Feb 1, 2016 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince Feb 19, 2024 Accepting new patients
Premier Healthcare, Inc. CurrentSince Feb 1, 2016 Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

460 W 34th St
New York, NY 10001
Phone (212) 273-6515

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

Networks

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

Interoperability endpoints

  • Direct secure messaging: mboahemaa4086235@nychhc.direct-ci.com

Organizations & group practices 3

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": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1164718359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 W 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012382",
            "telephone_number": "212-926-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 8TH AVE APT 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302454",
            "telephone_number": "212-926-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAHEMAA",
        "first_name": "MILLICENT",
        "middle_name": "AKOSUA",
        "name_prefix": "Miss",
        "credential": "F.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-26",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335757-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.