NPIMap

Individual provider Active NPI

Vlaicu Alin Botoman, MD

  • Gastroenterology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1386670677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME67172 Issued in FL
Practice address
2021 E Commercial Blvd
Suite 202
Fort Lauderdale, FL 33136-1005
Phone
(954) 202-7850
Fax
(954) 202-7781
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME67172 FL Primary

Addresses

Primary practice location

2021 E Commercial Blvd
Suite 202
Fort Lauderdale, FL 33136-1005

Mailing address

2021 E Commercial Blvd
Suite 202
Fort Lauderdale, FL 33308-3763
Phone (954) 202-7850

Other identifiers 1

IdentifierTypeStateIssuer
3767655-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150707000577 MA Practitioner - GastroenterologyPractitioner - Internal Medicine 3072411594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Johns Hopkins University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Upper gastrointestinal (GI) endoscopy for acid reflux142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME67172FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 1, 2015 Accepting new patients
The General Hospital Corporation CurrentSince Jul 1, 2015 Accepting new patients
Gastroenterology Assoc PA Past Accepting new patients
Coral Ridge Gastroenterology Associates LLC Gastroenterology Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: botoman.vlaicu.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386670677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083763",
            "telephone_number": "954-202-7850",
            "fax_number": "954-202-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E COMMERCIAL BLVD",
            "address_2": "SUITE 202",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "954-202-7850",
            "fax_number": "954-202-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTOMAN",
        "first_name": "VLAICU",
        "middle_name": "ALIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME67172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3767655-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.