Boaz Ovadia, M.D.

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

A92477 Issued in CA

Practice address

7060 N Recreation Ave
Suite 101
Fresno, CA 93720-8022

Phone

(559) 325-5656

Fax

(559) 325-5568

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, IL2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bovadia25483@direct.centracare.com

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.

• Community Foundation Medical Group

  dba Sante' Foundation Medical Group

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1811258510
  Medicare reassignment NPD
• Carle Health Care Incorporated

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Community Foundation Medical Group

  dba Sante' Foundation Medical Group

  • Orthopaedic Surgery Physician
  • Fresno, CA
  • NPI 1376056721
  NPD
• Valley Children's Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  NPD (past)
• Florida Em-I Medical Services, PA

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1083046049
  NPD (past)
• Virginia Hospitalists Inc

  dba Virginia Hospitalists

  • Internal Medicine Physician
  • Richmond, VA
  • NPI 1427047562
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1952436289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7060 N RECREATION AVE",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208022",
            "telephone_number": "559-325-5656",
            "fax_number": "559-325-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVADIA",
        "first_name": "BOAZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A92477",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME104618",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MN",
            "license": "105369- TEMP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001125800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BV993Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Dipondo Ouma, MD
• Sandy Ounmano
• Our Fathers Home LLC
• Talar Anya Ourfalian
• Kaitlin Outfleet
• Eric Ovalle
• Mao Ovalle
• Mary Clare Ovalle, RD, IBCLC
• Richard Xavier Ovalle Jr.
• Bryan Ovalles

• Pediatric Critical Care Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.