Raveena Saraswathi Boodram

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

94-12093 Issued in KS

Practice address

3901 Rainbow Blvd # Ms 1023
Kansas City, KS 66160-1005

Phone

(913) 588-6019

NPI assigned

Mar 30, 2022

Sex

Female

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

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1295475002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # 1023",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-6019",
            "fax_number": "913-588-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 1023",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661601005",
            "telephone_number": "913-588-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODRAM",
        "first_name": "RAVEENA",
        "middle_name": "SARASWATHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KS",
            "license": "94-12093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Robert Bond, MD
• Debra Ann Bonds, CERTIFIED HAIR LOSS
• John Anthony Bonino, M.D.
• Rachel Bonk, DO
• Luke Bontrager, MD
• Kanachai Boonpiraks, M.D.
• Jeffrey L. Borders, MD
• Steven William Bormann, M.D.
• Sydney L Bormann, MD
• Wendi Kay Born, PHD

• All providers in Kansas City, KS
• Gastroenterology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.