Kevin Michael Boehm, MD, PHD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

327230 Issued in NY

Practice address

1275 York Ave
New York, NY 10065-6007

Phone

(212) 639-5730

NPI assigned

Mar 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: kboehm96219@mskcc.direct-ci.com

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703980800000",
    "number": "1184373334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E 61ST ST # 321G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658204",
            "telephone_number": "646-608-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2023-12-31",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "327230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana Nicole Bodziuch, PHARMD
• Andrea Nicole Boe
• Chloe Kazuko Boehm, MD
• Christopher Boehm, LAC
• Kaitlin Boehm, MD
• Lauren Boehm
• Melanie Frances Boehmer, MS, RD, CDN
• Jaap-Jan Boelens, MD, PHD
• Brianna August Boelte
• Rachel Marie Boelter, LCAT, RDT

• General Practice Physician in New York, NY
• Providers in New York, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.