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RICHARD BOEHM
NPI 1104049501
Eyewear Supplier in Ardmore, PA

Active since April 11, 2007
17 E LANCASTER AVE, ARDMORE, PA 19003(610) 645-0546 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Richard Boehm NPPES

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

RICHARD BOEHM (NPI 1104049501) is an individual eyewear supplier provider in Ardmore, Pennsylvania, licensed in New Jersey (NJ D-1242) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1104049501
Entity TypeIndividualMale
Primary Taxonomy332H00000X
Provider Legal NameRICHARD BOEHM
Location Address17 E LANCASTER AVEArdmore, PA 19003-2319
Mailing Address17 E Lancaster AveArdmore, PA 19003-2319
Phone(610) 645-0546
Sole ProprietorYes
Enumeration DateApril 11, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1104049501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License✔ Licensed in NJ · NJ D-1242
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
17 E LANCASTER AVE, Ardmore, PA 19003
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Other Identifiers 1

Medicare ID-Type UnspecifiedA08008821PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, revalidation, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Richard Boehm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20100930058735DME · OpticianDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

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 Richard Boehm's NPI number?

The NPI number for Richard Boehm is 1104049501. It was assigned to this individual provider in the NPPES registry on April 11, 2007.

Where is Richard Boehm located?

Richard Boehm practices at 17 E Lancaster Ave, Ardmore, PA 19003. The listed phone number is (610) 645-0546.

What is Richard Boehm's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Is Richard Boehm enrolled in Medicare?

Yes. Richard Boehm is registered in the Medicare PECOS enrollment system.

When is Richard Boehm's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this provider (Pennsylvania, Optician) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Richard Boehm was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.