Individual provider Active NPI

Boma Afonya, MD

  • Psychiatry Physician
  • Fergus Falls, MN
National Provider Identifier
1881271385
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
80441 Issued in MN
Practice address
1801 W Alcott Ave
Fergus Falls, MN 56537-2661
Phone
(218) 332-5001
NPI assigned
Mar 29, 2021
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 80441 MN Primary
Psychiatry Physician 2084P0800X 324793 NY

Addresses

Primary practice location

1801 W Alcott Ave
Fergus Falls, MN 56537-2661

Mailing address

111 E 77TH St
New York, NY 10075-1802

Other practice location 1

111 E 77th St
New York, NY 10075-1802
Phone (212) 434-2810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260227002710 MN Practitioner - Psychiatry 0840776696
I20260416002185 CA Practitioner - Psychiatry 0840776696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Cincinnati College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

274 Madison Ave
RM 1501
New York, NY 10016-0720

3200 Labore Rd
Suite 104
Vadnais Heights, MN 55110-5130

5757 Wilshire Blvd
Suite 448
Los Angeles, CA 90036-3658

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80441MNMDPsychiatry Physician
324793NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rivia Medical PLLC CurrentSince Jan 6, 2026 Accepting new patients
Community Behavioral Health Hospital-Fergus Falls Single Specialty CurrentSince Feb 25, 2026 Accepting new patients

Locations

274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1881271385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W ALCOTT AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372661",
            "telephone_number": "218-332-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 77th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751802",
            "country_code": "US",
            "telephone_number": "212-434-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AFONYA",
        "first_name": "BOMA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "80441",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "324793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.