Active NPI
Freda Owusua Boateng, M.D.
- Internal Medicine Physician
- Bridgeport, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 045811
- Practice address
- 267 Grant St
Bridgeport, CT 06610-2805 - Phone
- (203) 384-4677
- Fax
- (203) 384-3135
- NPI assigned
- Oct 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 045811 | CT | |
| Hospitalist Physician | 208M00000X | 045811 | CT | |
| Internal Medicine Physician | 207R00000X | 045811 | CT | Primary |
Addresses
Primary practice location
267 Grant St
Bridgeport, CT 06610-2805
Mailing address
850 Mix Ave
Hamden, CT 06514-2102
Phone (203) 281-3500
Other practice location 1
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4748
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000
Hospital & facility affiliations
- Kaiser Foundation Hospital - Fremont
- Kaiser Foundation Hospital - San Leandro
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045811 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solano Gateway Medical Group Inc | Current | Accepting new patients | |
| Quantum Healthcare Medical Associates Inc. | Internal Medicine | Current | Accepting new patients |
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Complete Health LLC | Internal Medicine | Current | Accepting new patients |
| Quantum Bay Area Hospitalist Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Permanente Medical Group Inc | Internal Medicine | Current | Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051
2500 Merced St
San Leandro, CA 94577
Phone (510) 454-1000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Totality Home Health Care Agency LLC | Home health agency | 5% Or Greater Direct Ownership Interest (25%) | Feb 1, 2013 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Milford, CT
- NPI 1306198197
5% Or Greater Direct Ownership Interest
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
- Hospitalist Physician
- Mountain View, CA
- NPI 1902279656
Internal Medicine
-
- Hospitalist Physician
- Colton, CA
- NPI 1568490597
Internal Medicine
-
- Emergency Medicine Physician
- Fairfield, CA
- NPI 1952344293
-
- Internal Medicine Physician
- Bridgeport, CT
- NPI 1447656079
-
- Internal Medicine Physician
- Richmond, CA
- NPI 1235226531
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Leandro, CA
- NPI 1649605403
-
- General Acute Care Hospital
- Fremont, CA
- NPI 1801960513
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1386832848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 MIX AVE",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065142102",
"telephone_number": "203-281-3500",
"fax_number": "203-688-4740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 GRANT ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066102805",
"telephone_number": "203-384-4677",
"fax_number": "203-384-3135"
}
],
"practiceLocations": [
{
"address_1": "20 York St",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103220",
"country_code": "US",
"telephone_number": "203-688-4748",
"fax_number": "203-688-4740",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOATENG",
"first_name": "FREDA",
"middle_name": "OWUSUA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-10",
"last_updated": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "045811",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CT",
"license": "045811",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "045811",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2500 Merced St",
"city": "San Leandro",
"state": "CA",
"country_code": "US",
"postal_code": "945774201",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.