{
"Npi": {
"NPI": "1932167111",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BOOSER",
"FirstName": "ADAM",
"MiddleName": "CRAIG",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "601 ELMWOOD AVE BOX 604",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCHESTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14642-0001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "585-275-1385",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "601 ELMWOOD AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROCHESTER",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "14642-4619",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "585-275-1385",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/03/2006",
"LastUpdateDate": "03/12/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "2005021802",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207LP3000X",
"TaxonomyName": "Pediatric Anesthesiology Physician",
"LicenseNumber": "2005021802",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207LP3000X",
"TaxonomyName": "Pediatric Anesthesiology Physician",
"LicenseNumber": "04-31385",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "232453",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}