BONI S KOITHARA NP
NPI 1629746813
Nurse Practitioner - Family in Detroit, MI
About Boni S Koithara Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BONI S KOITHARA NP (NPI 1629746813) is an individual family provider in Detroit, Michigan, licensed in Michigan (4704237388) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, is affiliated with Sinai-grace Hospital, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Boni S Koithara Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Sinai-Grace Hospital
Acute Care Hospitals · Detroit, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DETROIT, MI 48201
DETROIT, MI 48201
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 Boni Koithara's NPI number?
The NPI number for Boni Koithara is 1629746813. It was assigned to this individual provider in the NPPES registry on September 1, 2021.
Where is Boni Koithara located?
Boni Koithara practices at 311 Mack Ave, Detroit, MI 48201. The listed phone number is (313) 745-3000.
What is Boni Koithara's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Boni Koithara enrolled in Medicare?
Yes. Boni Koithara is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Boni Koithara accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and McLaren Health Plan Community and 2 other insurers list Boni Koithara as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Boni Koithara affiliated with any hospitals?
According to CMS data, Boni Koithara is affiliated with Sinai-Grace Hospital.
When was this NPI record last updated?
The NPPES record for Boni Koithara was last updated on September 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Boni S Koithara, NP · NPI 1629746813
Family physician in Detroit, Michigan. Individual provider, active in the CMS NPPES registry since September 1, 2021.
## Identity
- **NPI:** 1629746813 (Entity type: Individual)
- **Enumerated:** September 1, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 4704237388 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 311 MACK AVE, Detroit, MI 48201-2466
- **Phone:** (313) 745-3000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 1, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1629746813) · Data from the CMS NPPES public registry.