NPIMap

Individual provider Active NPI

Shawn Eugene Boomsma, D.O.

  • Orthopaedic Trauma Physician
  • Miami, FL
National Provider Identifier
1407296486
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
OS16242 Issued in FL
Practice address
1800 NW 10TH Ave Ste T-215
Miami, FL 33136
Phone
(305) 585-1852
NPI assigned
Jul 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 273804 MA
Orthopaedic Trauma Physician 207XX0801X 273804 MA
Orthopaedic Trauma Physician 207XX0801X OS16242 FL Primary

Addresses

Primary practice location

1800 NW 10TH Ave Ste T-215
Miami, FL 33136

Mailing address

1800 NW 10TH Ave Ste T-215
Miami, FL 33136-1018
Phone (305) 585-1852

Other practice location 1

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201117000602 FL Practitioner - Orthopedic Surgery 6305161365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Oakland College of Medicine and Surgery, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 243-5302

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273804MAMDOrthopaedic Surgery Physician
OS16242FLMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Oct 23, 2020 Accepting new patients
University of Miami Orthopaedic Surgery CurrentSince Oct 23, 2020 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1800 NW 10th Ave
Ste T215
Miami, FL 33136
Phone (305) 585-1403

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: sboomsma170365@direct.med.miami.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1407296486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NW 10TH AVE STE T-215",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361018",
            "telephone_number": "305-585-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NW 10TH AVE STE T-215",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33136",
            "telephone_number": "305-585-1852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-724-0594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOMSMA",
        "first_name": "SHAWN",
        "middle_name": "EUGENE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "273804",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MA",
            "license": "273804",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "FL",
            "license": "OS16242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.