Andrea Boyle

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

LG-0001143 Issued in DE

Practice address

404 Fox Hunt Dr
Bear, DE 19701-2538

Phone

(302) 652-2455

Fax

(302) 322-6251

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Andrea Bommarito Former name

Medicare fee-for-service enrollment

Enrolled in DE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Westside Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wilmington, DE
  • NPI 1952303695

  DE

  Medicare reassignment NPD
• Westside Family Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Newark, DE
  • NPI 1801898556
  NPD

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1831549930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197200151",
            "telephone_number": "302-652-2455",
            "fax_number": "302-322-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 FOX HUNT DR",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012538",
            "telephone_number": "302-652-2455",
            "fax_number": "302-322-6251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Atlantic St SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20032",
            "country_code": "US",
            "telephone_number": "202-407-7747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R209259",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1019862",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1019862",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "DE",
            "license": "LG-0001143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BOMMARITO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Boruchov, MS.ED, PD, NCSP
• Amanda Jennifer Bostick, FNP-C
• Pratiksha Bothara
• Boyan Health Care and Staffing Agency
• Briana Boyd, MS, CCC-SLP
• Jennifer Bracken
• Brandywine Podiatry PA
• Jodie Marie Braswell, OTR/L
• Sarah K Brennan, D.P.T.
• Monique R Brown, MOTR/L

• All providers in Bear, DE
• Primary Care Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.