Active NPI
Deyanna Boston, M.D.
- Family Medicine Physician
- Omaha, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 32491
- Practice address
- 7710 Mercy Rd Ste 202
Omaha, NE 68124-2353 - Phone
- (402) 280-4675
- NPI assigned
- May 11, 2017
- Last updated
- Sep 10, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Family Medicine Physician | 207Q00000X | 32491 | NE | Primary |
Addresses
Primary practice location
7710 Mercy Rd Ste 202
Omaha, NE 68124-2353
Mailing address
2400 W Villard Ave
Milwaukee, WI 53209-4901
Phone (414) 527-8348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- 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
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2412 Cuming St
Suite 200
Omaha, NE 68131-1601
Phone (402) 717-0800
2915 Grant St
Omaha, NE 68111-3863
Phone (402) 457-1200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles Drew Health Center, Inc. | Current | Accepting new patients | |
| Charles Drew Health Center, Inc | Current | Accepting new patients | |
| Alegent Creighton Clinic | Family Medicine | Current | Accepting new patients |
| Charles Drew Health Center Inc | Past | Accepting new patients | |
| Alegent Health Immanuel Medical Center | Past | Accepting new patients |
Locations
2771 Solution Ctr
Chicago, IL 60677
16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920
2412 Cuming St
Ste 200
Omaha, NE 68131
Phone (402) 717-0380
2915 Grant St
Omaha, NE 68111
Phone (402) 451-3553
5904 Henniger Ave
Omaha, NE 68183
Phone (402) 444-4231
Interoperability endpoints
- deyanna.boston.d1.p1@direct.charlesdrew.nextgenshare.com
Organizations & group practices 5
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.
-
dba Charles Drew Health Center, Inc at Grant Street
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1255302170
-
dba Charles Drew Health Center Inc at Benson SBHC
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1215767421
-
dba CHI Health Immanuel
- General Acute Care Hospital
- Omaha, NE
- NPI 1912085184
-
dba Charles Drew Health Center Inc Mobile Medical
- Federally Qualified Health Center (FQHC)
- Omaha, NE
- NPI 1386218212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1689100539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 W VILLARD AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532094901",
"telephone_number": "414-527-8348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7710 MERCY RD STE 202",
"city": "OMAHA",
"state": "NE",
"postal_code": "681242353",
"telephone_number": "402-280-4675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTON",
"first_name": "DEYANNA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-11",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "32491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.