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MARY ROSE BOEHM MD PA
NPI 1053402156
Internal Medicine in Clermont, FL

Active since September 27, 2006
200 E HIGHLAND AVE, SUITE #2, CLERMONT, FL 34711(352) 242-1430(352) 242-1452 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mary Rose Boehm Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY ROSE BOEHM MD PA (NPI 1053402156) is a healthcare organization registered as an internal medicine in Clermont, Florida and active in the NPI registry since September 2006. The organization lists Mary Rose Boehm, President, as its authorized official.

NPPES Registry Identity

NPI1053402156
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMARY ROSE BOEHM MD PA
Location Address200 E HIGHLAND AVE, SUITE #2Clermont, FL 34711-2582
Mailing Address614 E Highway 50, Box 304Clermont, FL 34711-3164 · (352) 242-1430 · Fax (352) 242-1452
Phone(352) 242-1430
Fax(352) 242-1452
Organization SubpartNo
Authorized OfficialMary Rose BoehmPresident · (352) 242-1430
Enumeration DateSeptember 27, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1053402156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME 88288
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
200 E HIGHLAND AVE, Clermont, FL 34711
Open in Google Maps ↗

Other Identifiers 2

Other7042549FL · Aetna
Other81213FL · Blue Cross/blue Schield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Rose Boehm Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mary Rose Boehm MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mary Rose Boehm, MD
Internal Medicine
NPI 1770674715
200 E. HIGHLAND AVE. SUITE 2
Clermont, FL 34711
(352) 242-1430
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Rose Boehm MD PA's NPI number?

The NPI number for Mary Rose Boehm MD PA is 1053402156. It was assigned to this organization in the NPPES registry on September 27, 2006.

Where is Mary Rose Boehm MD PA located?

Mary Rose Boehm MD PA is located at 200 E Highland Ave Suite #2, Clermont, FL 34711. The listed phone number is (352) 242-1430.

What is Mary Rose Boehm MD PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mary Rose Boehm MD PA enrolled in Medicare?

Yes. Mary Rose Boehm MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mary Rose Boehm MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Mary Rose Boehm MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mary Rose Boehm MD PA was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.