Dorothy C Boersma, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01028107 Issued in IN

Practice address

401 E 34TH St
Indianapolis, IN 46205-3754

Phone

(317) 926-1507

Fax

(317) 926-1508

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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.

• Raphael Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1487764759

  Family Medicine, IN

  Medicare reassignment NPD
• Raphael Health Center, Inc

  • Pharmacy
  • Indianapolis, IN
  • NPI 1194582221
  NPD
• Meridian Health Services Corp

  • Rural Health Clinic/Center
  • Rushville, IN
  • NPI 1477504181
  NPD (past)
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford City, IN
  • NPI 1245094028
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FDCGDD

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 24, 2016.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1174544530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 34TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053754",
            "telephone_number": "317-926-1507",
            "fax_number": "317-926-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 34TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053754",
            "telephone_number": "317-926-1507",
            "fax_number": "317-926-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERSMA",
        "first_name": "DOROTHY",
        "middle_name": "C",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01028107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "46698002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216190",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Lynn Boelke, PHARMD, BCACP
• Corey Kenneth Boemer, PA
• Charline Sarah Boente, MD
• Erin Christine Boente, MD
• Ryan David Boente, MD
• Shannon Marie Boes, DO
• Alicia Boesgaard, RN
• Jeffrey A Boester, MD
• Andrew Thomas Boettger
• Jolynn Faith Bofah, DNP, CNM

• All providers in Indianapolis, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.