ALBERT BOHOLST, DMD, PA — NPI 1366742819 (Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment in HERNANDO, FL)

CMS-1500 Box 24J / 33a • NPI

1366742819

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

332BC3200X

Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment

Box 32 Service Location & ZIP+4

2623 N FOREST RIDGE BLVD, HERNANDO, FL, 34442-5123

✓ 9-Digit EDI 837 ZIP+4 (34442-5123)

Practice Phone & Referral Fax

(813) 746-4684

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366742819 (ALBERT BOHOLST, DMD, PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1366742819` (NPI-2 Organization / Facility)
Provider / Legal Name	ALBERT BOHOLST, DMD, PA
Plain-English Specialty	Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment NUCC Code: `332BC3200X` (Durable Medical Equipment & Medical Supplies, Customized Equipment)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2623 N FOREST RIDGE BLVD, HERNANDO, FL, 34442-5123
Practice Telephone / Fax	Tel: (813) 746-4684
Administrative Mailing Address	27510 CASHFORD CIR, WESLEY CHAPEL, FL, 33544-6910
Enumeration & Last Sync	Enumerated: 2010-11-01 \| CMS Record Updated: 2010-11-01
Authorized Official	ALBERT BOHOLST (Dentist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2623 N FOREST RIDGE BLVD, HERNANDO, FL, 34442-5123

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Plain-English Taxonomy & CMS Crosswalk (332BC3200X)

What Does Taxonomy Code 332BC3200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 332BC3200X translates to:
"Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Durable Medical Equipment & Medical Supplies, Customized Equipment for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALBERT BOHOLST, DMD, PA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`332BC3200X` — Durable Medical Equipment & Medical Supplies, Customized Equipment Plain English: Licensed & Credentialed Durable Medical Equipment & Medical Supplies, Customized Equipment	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ALBERT BOHOLST, DMD, PA (NPI #1366742819)