Individual provider Active NPI

Toni Boom

  • Occupational Therapist
  • Sacramento, CA
National Provider Identifier
1205243185
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9263 Issued in CA
Practice address
1238 S St
Society for the Blind
Sacramento, CA 95811-7112
Phone
(916) 452-8271
NPI assigned
Jul 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 9263 CA Primary
Low Vision Occupational Therapist 225XL0004X 9263 CA

Addresses

Primary practice location

1238 S St
Society for the Blind
Sacramento, CA 95811-7112

Mailing address

1238 S St
Society for the Blind
Sacramento, CA 95811-7112
Phone (916) 452-8271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141020001469 CA Practitioner - Occupational Therapist in Private Practice 1658592423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Society for the BlindGroup PAC ID 4789723446, 4 clinicians

Practice addresses (Care Compare)

1238 S St
Sacramento, CA 95811-7112
Phone (916) 452-8271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9263CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Society for the Blind CurrentSince Sep 18, 2014 Accepting new patients

Locations

1238 S St
Sacramento, CA 95811
Phone (916) 452-8271

Organizations & group practices 1

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": "1405123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1205243185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 S ST",
            "address_2": "SOCIETY FOR THE BLIND",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958117112",
            "telephone_number": "916-452-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 S ST",
            "address_2": "SOCIETY FOR THE BLIND",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958117112",
            "telephone_number": "916-452-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOM",
        "first_name": "TONI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-12",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "9263",
            "primary": true
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "CA",
            "license": "9263",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.