NPIMap

Individual provider Active NPI

Benjamin Michael Boral, D.O.

  • Internal Medicine Physician
  • Lexington, KY
National Provider Identifier
1922442656
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-9631 Issued in AR
Practice address
740 S Limestone St
K506 Kentucky Clinic
Lexington, KY 40536-0284
Phone
(859) 323-9918
NPI assigned
Apr 24, 2013
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-9631 AR Primary

Addresses

Primary practice location

740 S Limestone St
K506 Kentucky Clinic
Lexington, KY 40536-0284

Mailing address

2710 S Rife Medical LN
K506 Kentucky Clinic
Rogers, AR 72758-1452
Phone (479) 338-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160907002690 AR Practitioner - Internal Medicine 0648585695 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Memorial University Medical Department, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, shared by 5 NPIs, 314 clinicians

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 338-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Hospital Berryville CurrentSince Mar 1, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 1, 2016 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 28, 2021 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Aug 1, 2016 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

214 Carter St
Berryville, AR 72616
Phone (870) 423-3355

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

2710 S Rife Medical Ln
#K506
Rogers, AR 72758

Organizations & group practices 5

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1922442656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "address_2": "K506 KENTUCKY CLINIC",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-338-8000",
            "fax_number": "479-338-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE ST",
            "address_2": "K506 KENTUCKY CLINIC",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284",
            "telephone_number": "859-323-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORAL",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-9631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.