Kailip Boonrai, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

341301 Issued in NY

Practice address

1140 Seneca Ave
Ridgewood, NY 11385-6067

Phone

(718) 571-6300

NPI assigned

Apr 5, 2023

Last updated

Jul 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

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 Medicine

Education

New York Medical College, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1376238444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 PARK PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "914-798-8971",
            "fax_number": "854-300-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SENECA AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113856067",
            "telephone_number": "718-571-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONRAI",
        "first_name": "KAILIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "341301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denis Eduardo Blumberg, LCSW, CASAC
• Bonafide Eyewear LLC (Bonafide Eyeware)
• Frank M Bone, DDS
• Dexter Bongato
• Jaclyn Bonnici
• Anna Kubicz Borowik, MSPT
• Patricia Lynn Bower, LPN
• P Brathwaite, OTR/L
• Jason Brattner, DC
• Celina Bravo

• Internal Medicine Physician in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.