Justin Luke Boren, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1296 Issued in TN

Practice address

832 Westover Dr Ste 200
Columbia, TN 38401-4843

Phone

(931) 830-3033

Fax

(931) 388-3401

NPI assigned

Jan 4, 2007

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tennessee Oncology PLLCGroup PAC ID 4688586134, 355 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maury Regional Hospital Hospital, Columbia, TN, CCN 440073

Merit-based Incentive Payment System (MIPS)

Final score

85.69 of 100Reported as group

Quality

70.45

Promoting interoperability

100

Improvement activities

40

Cost

73.38

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Tennessee Oncology PLLC

  • Hematology & Oncology Physician
  • Nashville, TN
  • NPI 1811955917
  Medicare reassignment Care Compare group NPD
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  Medicare reassignment
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  Medicare reassignment
• The Surgical Clinic PLLC

  • Surgery Physician
  • Nashville, TN
  • NPI 1417983099
  Medicare reassignment
• Tennessee Oncology

  dba Chattanooga PET and Imaging Center

  • Diagnostic Radiology Physician
  • Chattanooga, TN
  • NPI 1912623364
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Maury Regional Hospital

  dba Lewis Ambulatory Care Center

  • Clinic/Center
  • Hohenwald, TN
  • NPI 1023038122

  Hospital

  Care Compare affiliation
• Maury Regional Hospital

  dba Maury Regional Medical Center

  • General Acute Care Hospital
  • Columbia, TN
  • NPI 1861479545
  Care Compare affiliation

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1053468199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 42ND AVE N STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372093658",
            "telephone_number": "615-329-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 WESTOVER DR STE 200",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014843",
            "telephone_number": "931-830-3033",
            "fax_number": "931-388-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "JUSTIN",
        "middle_name": "LUKE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4142242",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874485289B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00382564",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874485289A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009941922",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Carlton Bolton, REGISTERED NURSE
• Deanna Michelle Bommarito
• Lindsey Hawthorne Bonas-Page
• Samuel Booker
• Hannah Elizabeth Boren, PHARMD
• Rhennetta Bork, DPM
• Nina Elizabeth Boshers, LMFT
• Brice T. Boughner, MD
• Karen Hunnicutt Bowden, MS, CCC-SLP
• Gregory Richard Bowers, M.D.

• Physician Assistant in Columbia, TN
• Providers in Columbia, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.