Individual provider Active NPI

Kwadwo O Boadi, MD

  • Anesthesiology Physician
  • Culpeper, VA
National Provider Identifier
1215946363
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101241304 Issued in VA
Practice address
501 Sunset Lane
Culpeper, VA 22701-3917
Phone
(540) 829-4100
NPI assigned
Aug 7, 2006
Last updated
Aug 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101241304 VA Primary
Internal Medicine Physician 207R00000X 041029 CT

Addresses

Primary practice location

501 Sunset Lane
Culpeper, VA 22701-3917

Mailing address

12012 Veirs Mill Rd
Silver Spring, MD 20906-4513
Phone (209) 956-7725

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090106000195 DC Practitioner - Anesthesiology 7315928744 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101241304VAMDAnesthesiology Physician
041029CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Nov 13, 2021 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Nov 13, 2021 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients
Pine Ridge Indian Health Service Hospital Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

12012 Veirs Mill Rd
Silver Spring, MD 20906
Phone (301) 370-0810

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1215946363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12012 VEIRS MILL RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064513",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SUNSET LANE",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "227013917",
            "telephone_number": "540-829-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOADI",
        "first_name": "KWADWO",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101241304",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "041029",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culpeper, VA

Sources for this page

Verify at the official NPI Registry.