Individual provider Active NPI

William O Boah, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1811087570
Registry record updated May 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
130416 Issued in NY
Practice address
145 E 18TH St
Brooklyn, NY 11226-4362
Phone
(718) 282-9690
Fax
(718) 287-5915
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 130416 NY Primary

Addresses

Primary practice location

145 E 18TH St
Brooklyn, NY 11226-4362

Mailing address

145 E 18TH St
Brooklyn, NY 11226-4362
Phone (718) 282-9690

Other identifiers 1

IdentifierTypeStateIssuer
00368447MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160907002909 NY Practitioner - Family Practice 1759677321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
130416NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
William O Boah MD LLP Pediatrics CurrentSince May 14, 2016 Accepting new patients

Organizations & group practices 1

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463184000000",
    "number": "1811087570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E 18TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264362",
            "telephone_number": "718-282-9690",
            "fax_number": "718-287-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E 18TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264362",
            "telephone_number": "718-282-9690",
            "fax_number": "718-287-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAH",
        "first_name": "WILLIAM",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "130416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00368447",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.