Aishah Boodram, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16655 Issued in FL

Practice address

10139 Beach Port Dr
Winter Garden, FL 34787-4413

Phone

(618) 472-8964

Fax

(404) 487-8907

NPI assigned

May 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Aisha Khan Former name

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Positive Strides LLC

  • Clinical Social Worker
  • Winter Garden, FL
  • NPI 1982151338
  Medicare reassignment Authorized official
• Peachtree Hospice of Georgia, LLC

  dba BridgeWay Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Stockbridge, GA
  • NPI 1255788436
  Medicare reassignment NPD
• Ultima Rehab-FL LLC

  • Geriatric Physical Therapist
  • North Fort Myers, FL
  • NPI 1053970194
  NPD

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1689052813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10139 BEACH PORT DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874413",
            "telephone_number": "678-472-8964",
            "fax_number": "404-487-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10139 BEACH PORT DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874413",
            "telephone_number": "618-472-8964",
            "fax_number": "404-487-8907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Windgrove Ln",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300247010",
            "country_code": "US",
            "telephone_number": "678-472-8964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOODRAM",
        "first_name": "AISHAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004935",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AISHA",
            "last_name": "KHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cherron Boisselle
• Lindsey Bolen
• Mary Beth Bond, SLP
• Karla Bonetti, APRN
• Alison Bongo
• Boomerang Home Services (Age Advantage HCS)
• Nicole Leigh Borah, APRN, FNP-C
• Rute Borges Cardoso, MD
• Babak Boroujerdi, D.O.
• Amine Bouri

• Clinical Social Worker in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.