NPIMap

Individual provider Active NPI

Jeffrey William Boss, MD

  • Diagnostic Radiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1053576827
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2012031845 Issued in MO
Practice address
70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone
(573) 334-6071
Fax
(573) 334-4739
NPI assigned
Jul 22, 2008
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2012031845 MO Primary

Addresses

Primary practice location

70 Doctors Park
Cape Girardeau, MO 63703-4928

Mailing address

70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, KY, FL4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20160608000258 MO Practitioner - Diagnostic Radiology 9133363344 Reassigns benefits to 3 organizations
I20160705001589 IL Practitioner - Diagnostic Radiology 9133363344 Reassigns benefits to 1 organization
I20230523002669 KY Practitioner - Diagnostic Radiology 9133363344 Reassigns benefits to 1 organization
I20260522002674 FL Practitioner - Diagnostic Radiology 9133363344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Louisville School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Radiology Group PCGroup PAC ID 9830093236, 54 clinicians
Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Practice addresses (Care Compare)

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (270) 444-2444

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

434 N W St
Perryville, MO 63775-1359
Phone (573) 547-2536

976 Grand Canal St
Gulf Breeze, FL 32563-3053
Phone (573) 335-6671

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012031845MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry Diagnostic Radiology Current Accepting new patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients

Locations

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1053576827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSS",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2012031845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.