Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Boni S Koithara, NP

Individual provider Family Nurse Practitioner · NPI 1629746813

Boni S Koithara, NP is a Nurse Practitioner in Detroit, Michigan. Qualified in 2020, 6 years ago. Practices with Vhs Physicians of Michigan, a 217-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
6
Licensed in
MI
In the registry since
2021
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

311 Mack Ave
Detroit, MI 48201-2466
Phone: (313) 745-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704237388 (MI)

Record details

NPI number1629746813
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedSeptember 1, 2021
Last updated in NPPESSeptember 1, 2021
Certification dateSeptember 1, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Vhs Physicians Of Michigan — 217 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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