Individual provider Active NPI

Mercedes Boggs

  • Emergency Medicine Physician
  • University Park, PA
National Provider Identifier
1013173046
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT192709 Issued in PA
Practice address
308 Student Health Ctr
University Park, PA 16802-2129
Phone
(814) 863-6747
NPI assigned
Jul 29, 2008
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT192709 PA Primary

Addresses

Primary practice location

308 Student Health Ctr
University Park, PA 16802-2129

Mailing address

308 Student Health Ctr
University Park, PA 16802-2129

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000316 PA Practitioner - Emergency Medicine 2365612462 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT192709PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince Aug 1, 2011 Accepting new patients
Upmc Altoona CurrentSince Aug 1, 2011 Accepting new patients
Lock Haven Emergency Physicians PLLC Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients

Locations

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

24 Cree Dr
Lock Haven, PA 17745
Phone (570) 893-5000

Interoperability endpoints

  • Direct secure messaging: upmchospitals@upmcdirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1013173046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 STUDENT HEALTH CTR",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168022129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 STUDENT HEALTH CTR",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168022129",
            "telephone_number": "814-863-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "MERCEDES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2021-06-15",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT192709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in University Park, PA

Sources for this page

Verify at the official NPI Registry.