Fredric Bomback, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

106826 Issued in NY

Practice address

99 Fieldstone Dr
Hartsdale, NY 10530-1564

Phone

(914) 428-2120

NPI assigned

Jan 6, 2006

Last updated

Jan 28, 2014By 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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: fbomback@hiemail.healtheconnections.org
• Direct secure messaging: fredric.bomback.1@21260.direct.athenahealth.com
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347

  Pediatrics

  Medicare reassignment NPD
• Westchester Medical Group, P.C.

  dba WESTMED Medical Group

  • Critical Care Medicine (Internal Medicine) Physician
  • Rye Brook, NY
  • NPI 1881653822

  Pediatrics

  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• The Westchester Medical Group PC

  dba Westmed Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Greenwich, CT
  • NPI 1790560878
  NPD
• Trustees of Columbia University in the City of New York

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • New York, NY
  • NPI 1760444822
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1417935628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 FIELDSTONE DR",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301564",
            "telephone_number": "914-428-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 FIELDSTONE DR",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301564",
            "telephone_number": "914-428-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBACK",
        "first_name": "FREDRIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "106826",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "106826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Black
• Reena Blum, LCSW
• Shanya Blye-Watt, LPN
• Leslie Bogen, JD, PHD
• Hipolito Taeza Bolanos, PT
• Lisa Maria Bonaviso
• Sharon Lorraine Bond Akuamoah
• Jennifer Bone
• Norma Luz Borrero-Large, LCSW
• Amber Bovenschulte

• Pediatrics Physician in Hartsdale, NY
• Providers in Hartsdale, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.