Individual provider Active NPI

Andrea Jo Boehm, FNP-BC

  • Family Nurse Practitioner
  • Saginaw, MI
National Provider Identifier
1801616859
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704349491 Issued in MI
Practice address
5483 Gratiot Rd
Saginaw, MI 48638-6037
Phone
(989) 583-5626
NPI assigned
Oct 15, 2024
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704349491 MI Primary

Addresses

Primary practice location

5483 Gratiot Rd
Saginaw, MI 48638-6037

Mailing address

5483 Gratiot Rd
Saginaw, MI 48638-6037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241023000630 MI Practitioner - Nurse Practitioner 3274066709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

5483 Gratiot Rd
Saginaw, MI 48638-6037
Phone (989) 799-5557

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince Oct 16, 2024 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients

Locations

2919 Wilder Rd
Ste 210
Bay City, MI 48706
Phone (989) 607-0590

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

5483 Gratiot Rd
Saginaw, MI 48638
Phone (989) 583-5626

Interoperability endpoints

  • Direct secure messaging: aboehm162952@direct.covenanthealthcare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1801616859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5483 GRATIOT RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5483 GRATIOT RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386037",
            "telephone_number": "989-583-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "ANDREA",
        "middle_name": "JO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704349491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.