Active NPI
Michael David Boron, MD
- Ophthalmology Physician
- Mount Vernon, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 199996-1
- Practice address
- 107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550 - Phone
- (914) 699-7200
- Fax
- (914) 699-0837
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 199996-1 | NY | Primary |
Addresses
Primary practice location
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Mailing address
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone (914) 699-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01877792 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Hahnemann University College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 199996-1 | NY | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Vernon Neighborhood Health Center, Inc. | Current | Accepting new patients | |
| Mount Vernon Neighborhood Health Center Inc | Current | Accepting new patients | |
| Mount Vernon Neighborhood Health Center, Inc. | Past | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Ophthalmology | Past | Accepting new patients |
Locations
107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235
295 Knollwood Rd
White Plains, NY 10607
Phone (914) 699-7200
30 S Broadway
Fl 2
Yonkers, NY 10701
Phone (914) 968-4898
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482
Organizations & group practices 4
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.
-
- Specialist
- Mount Vernon, NY
- NPI 1295912541
-
- Federally Qualified Health Center (FQHC)
- Yonkers, NY
- NPI 1952550055
-
- Federally Qualified Health Center (FQHC)
- Mount Vernon, NY
- NPI 1396736120
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
Ophthalmology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1992841464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WEST 4TH STREET",
"address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-699-7200",
"fax_number": "914-699-0837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WEST 4TH STREET",
"address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-699-7200",
"fax_number": "914-699-0837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORON",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "199996-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01877792",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.