Active NPI
Lars Boman, MD
- Public Health & General Preventive Medicine Physician
- Boston, MA
National Provider Identifier
1275562944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 60137
- Practice address
- 15 Broad St
#801
Boston, MA 02109-3803 - Phone
- (857) 239-9120
- Fax
- (857) 277-1355
- NPI assigned
- Jul 3, 2006
- Last updated
- Jun 8, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 60137 | MA | Primary |
Addresses
Primary practice location
15 Broad St
#801
Boston, MA 02109-3803
Mailing address
15 Broad St
#801
Boston, MA 02109-3803
Phone (857) 239-9120
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00028554 | Other | MA | BOSTON HEALTH NET |
| 4339-7 | Other | RI | BLUECROSS RI |
| 004624 | Other | RI | BLUECHIP |
| 8269 | Other | MA | HARVARD PILGRIM |
| 89755 | Other | MA | US HEALTHCARE |
| 42894 | Other | MA | CHILDRENS MEDICAL SECURI |
| 3037886 | Medicaid | MA | |
| 754146 | Other | MA | TUFTS |
| 1701023 | Other | MA | 1701023 |
| 125141400 | Other | MA | ACS/WORKERS COMP |
| 6351 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| J07574 | Other | MA | BLUECROSS BLUECHIELD OF M |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 30, 2014 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60137 | MA | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1275562944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 BROAD ST",
"address_2": "#801",
"city": "BOSTON",
"state": "MA",
"postal_code": "021093803",
"telephone_number": "857-239-9120",
"fax_number": "857-277-1355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BROAD ST",
"address_2": "#801",
"city": "BOSTON",
"state": "MA",
"postal_code": "021093803",
"telephone_number": "857-239-9120",
"fax_number": "857-277-1355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOMAN",
"first_name": "LARS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "MA",
"license": "60137",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOSTON HEALTH NET",
"identifier": "00028554",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS RI",
"identifier": "4339-7",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECHIP",
"identifier": "004624",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "8269",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "89755",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILDRENS MEDICAL SECURI",
"identifier": "42894",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3037886",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "754146",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1701023",
"identifier": "1701023",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS/WORKERS COMP",
"identifier": "125141400",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "6351",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUECHIELD OF M",
"identifier": "J07574",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.