Individual provider Active NPI

Beatrice Boham, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Leominster, MA
National Provider Identifier
1689330524
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2330665 Issued in MA
Practice address
1069 Central St
Leominster, MA 01453-4805
Phone
(978) 728-4957
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2330665 MA Primary

Addresses

Primary practice location

1069 Central St
Leominster, MA 01453-4805

Mailing address

1069 Central St
Leominster, MA 01453-4805
Phone (978) 728-4957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240624002989 MA Practitioner - Nurse Practitioner 4486197027 Reassigns benefits to 1 organization
I20260223000051 NY Practitioner - Nurse Practitioner 4486197027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4 Arapaho Rd
Worcester, MA 01606-2600

9520 63Rd Rd
Suite J
Rego Park, NY 11374-1145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2330665MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Neurobehavioral Associates, LLC Internal Medicine CurrentSince Jun 4, 2024 Accepting new patients
Queens Psychiatric & Medical Care P.C. Psychiatric/Mental Health CurrentSince Dec 16, 2025 Accepting new patients

Locations

226 Field St
New Bedford, MA 02740
Phone (508) 817-5129

9520 63rd Rd
Ste J
Rego Park, NY 11374
Phone (718) 459-5812

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1689330524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 CENTRAL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534805",
            "telephone_number": "978-728-4957",
            "fax_number": "978-798-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 CENTRAL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534805",
            "telephone_number": "978-728-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHAM",
        "first_name": "BEATRICE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2330665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.