Imhotep Boukman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101263610 Issued in VA

Practice address

100 Sentara Cir RM 2C
Williamsburg, VA 23188-5713

Phone

(757) 984-7217

Fax

(757) 984-7210

NPI assigned

May 26, 2006

Last updated

Aug 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Meharry Medical College School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
• The Outer Banks Hospital, Inc Hospital, Nags Head, NC, CCN 341324
• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment Care Compare group
• PMR Virginia Holding, LLC

  dba Jencare Senior Medical Centers of Virginia

  • Specialist
  • Miami Gardens, FL
  • NPI 1083167001
  NPD
• Bayhealth Hospitalist, LLC

  • Hospitalist Physician
  • Milford, DE
  • NPI 1750527297
  NPD (past)
• Cogent Healthcare of Pennsylvania, Inc.

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1831126176
  NPD (past)
• Conemaugh Health Initiatives

  • Family Medicine Physician
  • New Paris, PA
  • NPI 1487724597
  NPD (past)
• Health Access Network

  • Physical Medicine & Rehabilitation Physician
  • Chester, PA
  • NPI 1356460380
  NPD (past)
• MD at Home, Inc

  • Adult Medicine Physician
  • York, PA
  • NPI 1578518015
  NPD (past)
• Specialty Physicians of LVHN PC

  • Plastic Surgery Physician
  • Bethlehem, PA
  • NPI 1497709042
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sentara Hospitals

  dba Sentara Nightingale

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Obici Hospital

  • General Acute Care Hospital
  • Suffolk, VA
  • NPI 1376540138
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Norfolk General Hospital

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• The Outer Banks Hospital Inc

  • Critical Access Hospital
  • Nags Head, NC
  • NPI 1053375253
  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1326094723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SENTARA CIR RM 2C",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885713",
            "telephone_number": "757-984-7217",
            "fax_number": "757-984-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SENTARA CIR RM 2C",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885713",
            "telephone_number": "757-984-7217",
            "fax_number": "757-984-7210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_2": "Suite AO-F300",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "215-707-0774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Old Denbigh Blvd Ste 1020A",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236022017",
            "country_code": "US",
            "telephone_number": "757-875-2009",
            "fax_number": "757-369-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUKMAN",
        "first_name": "IMHOTEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD418363",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101263610",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101263610",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001901656",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Boop
• Christopher G. Boquist, MD
• Luis J. Borda, M.D.
• Susanna Bose, WHNP-BC
• Sarah E Bott, P.A.
• Maureen Bounds, PHARM.D.
• Linda S. Bourdon, ED.D.
• Thomas P. Bowe Jr., D. D. S.
• Katherine Bowles
• Eric W. Boxx, D. M. D.

• Internal Medicine Physician in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.
• 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.