Boosara Ratanawongsa, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

MD431769 Issued in PA

Practice address

961 Marcon Blvd Ste 452
Allentown, PA 18109-9366

Phone

(610) 398-9898

Fax

(484) 245-5384

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Pediatric Neurology of Lehigh Valley, PC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Allentown, PA
  • NPI 1174929897
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1700949286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD STE 452",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099366",
            "telephone_number": "610-398-9898",
            "fax_number": "610-398-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD STE 452",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099366",
            "telephone_number": "610-398-9898",
            "fax_number": "484-245-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATANAWONGSA",
        "first_name": "BOOSARA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "PA",
            "license": "MD431769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel S Raphael, LPC
• Rapid RX Pharmacy LLC
• Wendy Myra Rapoport, MSW, LCSW
• Sarah Ann Rasich
• Daniel John Raskos Jr., DC
• David K Rath, PA-C
• Benjamas Deborah Rattananai, M.D.
• Albert Ratzin, PSY.D
• Olivia Rautzhan
• Mark A Ravago

• Neurology with Special Qualifications in Child Neurology Physician in Allentown, PA
• Providers in Allentown, PA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.