Boni S Koithara, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704237388 Issued in MI

Practice address

311 Mack Ave
Detroit, MI 48201-2466

Phone

(313) 745-3000

NPI assigned

Sep 1, 2021

Sex

Female

Sole proprietor

No

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024

Merit-based Incentive Payment System (MIPS)

Final score

90.26 of 100Reported as group

Quality

64.16

Promoting interoperability

100

Improvement activities

40

Cost

73.79

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: boni.koithara.1@9704.direct.athenahealth.com

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.

• VHS Physicians of Michigan

  dba DMC Medical Group

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment Care Compare group

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

• VHS Sinai-Grace Hospital Inc

  dba Sinai-Grace Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1760794044
  Care Compare affiliation

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1629746813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466",
            "telephone_number": "313-745-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466",
            "telephone_number": "313-745-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOITHARA",
        "first_name": "BONI",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704237388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnene K Koganti, M.S., PA-C
• Laurie Linden Kohen, M.D.
• Heather Kohl, LLBSW
• Lindsey M Kohler, N.P.
• Winnie Jepkogei Koima, NP
• Terezina Koje, DO
• Veronica Kokavec, M.S.
• Daniel Meressa Kokebu, M.D.
• Courtney Kokenakes, MS, CGC
• Lianne Alise Kokoska, PHARM.D.

• Family Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.