Boma Park, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

003455 Issued in NY

Practice address

107 W 4TH St
Mount Vernon, NY 10550-4002

Phone

(914) 699-7200

Fax

(914) 699-0837

NPI assigned

Dec 27, 2007

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Mount Vernon Neighborhood Health Center IncGroup PAC ID 0345139671, 48 clinicians

360 Complete Medical PCGroup PAC ID 5496299091, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Montefiore Mount Vernon Hospital Hospital, Mount Vernon, NY, CCN 330086

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

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.

• 360 Complete Medical PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1821762915
  Medicare reassignment Care Compare group NPD
• Mount Vernon Neighborhood Health Center Inc

  dba Mount Vernon Physician Group

  • Specialist
  • Mount Vernon, NY
  • NPI 1295912541
  Medicare reassignment Care Compare group NPD
• Mount Vernon Neighborhood Health Center, Inc.

  dba Westchester Community Health Center Yonkers

  • Federally Qualified Health Center (FQHC)
  • Yonkers, NY
  • NPI 1952550055
  NPD
• Mount Vernon Neighborhood Health Center, Inc.

  dba Westchester Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, NY
  • NPI 1396736120
  NPD (past)

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

• Montefiore Mount Vernon Hospital

  • General Acute Care Hospital
  • Mount Vernon, NY
  • NPI 1992131320
  Care Compare affiliation

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1730363623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WEST 4TH STREET",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10550",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BOMA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "003455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeneil Patrice Palmer
• Edwin Pan, MD
• Natia Pantsulaia
• Sopha Janel Parande
• Patricia Parchment-Falconer
• Kyung Sun Park, MD
• Seoung Sou Park, MD
• Erica Parker-Jackson
• Frederick Lawrence Parker, MD
• Ramona J Parker

• Internal Medicine Physician in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.