Individual provider Active NPI

Elaine Boehm, CNM

  • Advanced Practice Midwife
  • W. St. Paul, MN
National Provider Identifier
1295990901
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R-185338-2 Issued in MN
Practice address
153 Cesar Chavez St
W. St. Paul, MN 55107-2226
Phone
(651) 222-1816
Fax
(651) 222-1305
NPI assigned
Jul 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 185338-2 MN
Advanced Practice Midwife 367A00000X R-185338-2 MN Primary

Addresses

Primary practice location

153 Cesar Chavez St
W. St. Paul, MN 55107-2226

Mailing address

153 Cesar Chavez St
W. St. Paul, MN 55107-2226
Phone (651) 222-1816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000089 MN Practitioner - Certified Nurse Midwife (CNM) 6800961772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Side Community Health Services, Inc.Group PAC ID 2062306434, 51 clinicians

Practice addresses (Care Compare)

895 7TH St E
Saint Paul, MN 55106-3871
Phone (651) 602-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
185338-2MNMDAdvanced Practice Midwife
R-185338-2MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
West Side Community Health Services, Inc. Current Accepting new patients
West Side Community Health Services, Inc. CurrentSince Sep 2, 2008 Accepting new patients
West Side Community Health Services, Inc. CurrentSince Sep 2, 2008 Accepting new patients

Locations

895 7th St E
Saint Paul, MN 55106
Phone (651) 793-2250

153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816

Interoperability endpoints

  • Direct secure messaging: eboehm733008@direct.ochin.org

Organizations & group practices 3

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": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1295990901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 CESAR CHAVEZ ST",
            "city": "W. ST. PAUL",
            "state": "MN",
            "postal_code": "551072226",
            "telephone_number": "651-222-1816",
            "fax_number": "651-222-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 CESAR CHAVEZ ST",
            "city": "W. ST. PAUL",
            "state": "MN",
            "postal_code": "551072226",
            "telephone_number": "651-222-1816",
            "fax_number": "651-222-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "ELAINE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "185338-2",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R-185338-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W. St. Paul, MN

Sources for this page

Verify at the official NPI Registry.