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

Active since September 27, 2006CLIA 10D1022456 · Waiver
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: July 26, 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 holds a CLIA Waiver certificate valid through February 16, 2028 and 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
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

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1022456

Mary Rose Boehm MD PA · Clermont, FL
Active · expires Feb 16, 2028
CLIA Number10D1022456
Laboratory TypePhysician Office
Certificate Effective DateFebruary 17, 2026
Certificate Expiration DateFebruary 16, 2028
Laboratory DirectorMary R. Boehm MD
Laboratory Phone(352) 242-1430
Laboratory LocationMary Rose Boehm MD PA1655 East Highway 50 Suite 202, Clermont, FL 34711
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

General Practice
200 E HIGHLAND AVE
CLERMONT, FL 34711
General Practice
200 E HIGHLAND AVE
CLERMONT, FL 34711
Nurse Practitioner (Family)
200 E HIGHLAND AVE
CLERMONT, FL 34711
Clinic/Center (Primary Care)
200 E HIGHLAND AVE
CLERMONT, FL 34711

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.

Does Mary Rose Boehm MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1022456) is associated with this NPI, valid through February 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 with the weekly NPPES data releases published by CMS.