Robert J Boss, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD09837 Issued in OR

Practice address

450 Tatone Street
Boardman, OR 97818

Phone

(541) 481-7212

Fax

(541) 481-2020

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15532/brand/4/csg/1/fhir/r4

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

• Asher Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Fossil, OR
  • NPI 1811937485

  OR

  Medicare reassignment NPD
• Asher Community Health Center

  • Primary Care Clinic/Center
  • Fossil, OR
  • NPI 1033989439
  NPD

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1013900646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 397",
            "city": "BOARDMAN",
            "state": "OR",
            "postal_code": "97818",
            "telephone_number": "541-481-7212",
            "fax_number": "541-481-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 TATONE STREET",
            "city": "BOARDMAN",
            "state": "OR",
            "postal_code": "97818",
            "telephone_number": "541-481-7212",
            "fax_number": "541-481-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSS",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD09837",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD00017375",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004015",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maegan Bennett
• Matthew Jay Bergstrom
• Jessie Blakeman
• Boardman Fire Rescue District
• Boardman Hardware Inc
• Jennifer B Brock
• Vanessa Calvillo
• Anna Carl
• Mayra Colin Carrillo, LPC
• Da'Janee Monique Challis

• All providers in Boardman, OR
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.