Andra Margaret Boak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21455 Issued in MA

Practice address

245 First St
Cambridge, MA 02142-1200

Phone

(207) 490-6900

Fax

(207) 490-1188

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1770627358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FIRST ST",
            "address_2": "18TH FLLOR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421200",
            "telephone_number": "207-490-6900",
            "fax_number": "207-490-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FIRST ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421200",
            "telephone_number": "207-490-6900",
            "fax_number": "207-490-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAK",
        "first_name": "ANDRA",
        "middle_name": "MARGARET",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3795",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE CARE PROVIDER NUMBE",
            "identifier": "432332399",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bluesky Telepsych, Inc.
• Rachel Blum Cantone, LMFT
• Amy Christine Blume-Marcovici, PSY.D.
• John Frederick Blumenstiel, LCSW
• Hannah Blystone
• Carly Bobinsky, LICSW
• Nicole H Bodin, RD
• Roselynne Bodkin
• Terri Bogage, LICSW
• Dana Bogan, LICSW

• General Practice Dentistry in Cambridge, MA
• Providers in Cambridge, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.