Individual provider Active NPI

Olga Emilia Martinez Bohan, ARNP

  • Primary Care Nurse Practitioner
  • Largo, FL
National Provider Identifier
1174986038
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
9339667 Issued in FL
Practice address
12685 Starkey Rd
Largo, FL 33773-1421
Phone
(727) 535-9901
Fax
(727) 535-8760
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 9339667 FL Primary

Addresses

Primary practice location

12685 Starkey Rd
Largo, FL 33773-1421

Mailing address

2289 Hannah Way S
Dunedin, FL 34698-9452
Phone (727) 781-5976

Other identifiers 1

IdentifierTypeStateIssuer
9339667OtherFLSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170412001523 FL Practitioner - Nurse Practitioner 3072899780 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9339667FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Darig Pharmacy Past Accepting new patients
Jose a. Perez-Arce, MD PastSince Jan 14, 2017 Accepting new patients

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1174986038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2289 HANNAH WAY S",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346989452",
            "telephone_number": "727-781-5976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12685 STARKEY RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337731421",
            "telephone_number": "727-535-9901",
            "fax_number": "727-535-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ BOHAN",
        "first_name": "OLGA",
        "middle_name": "EMILIA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "9339667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "9339667",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.