Andrew Bostom, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD09437 Issued in RI

Practice address

593 Eddy St
Apc 9
Providence, RI 02903-4923

Phone

(401) 444-6460

Fax

(401) 444-2217

NPI assigned

May 20, 2006

Last updated

Aug 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Brown Medicine

  • Gastroenterology Physician
  • Providence, RI
  • NPI 1730827767
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1902850274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "APC 9",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6460",
            "fax_number": "401-444-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTOM",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD09437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00024512",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100339",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025311",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Borsari, PHD
• William Bortcosh, M.D.
• Jillian Borzain, OTR/L
• Lewis J Bosler, MA - COUNSELING PSYC
• Michael Anthony Bossi, LCSW
• Sonya Bostom, RD, LDN
• Boston Brace International Inc. (OP Specialty Bracing)
• Boston Therapy Inc (MED - Therapy)
• Sai Aishwarya Bosula, MD
• Boswell, Inc.

• Internal Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.