Gary Kenneth Boone, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

G31968 Issued in CA

Practice address

3737 Moraga Ave Ste B408
San Diego, CA 92117-5364

Phone

(858) 292-8885

Fax

(858) 292-0688

NPI assigned

Jul 5, 2006

Last updated

Nov 19, 2020By 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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

General Practice

Education

University of Southern California Keck School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• JTC Home Health Inc Home health agency, San Diego, CA, CCN 757351
• Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
• Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: garyboone@sdpcmg.allscriptsdirect.net
• Direct secure messaging: gboone32377@sharphealthcare.direct-ci.com

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.

• San Diego Primary Care Medical Group

  dba Clairemont Family Medical Clinic

  • Adult Medicine Physician
  • San Diego, CA
  • NPI 1932257193
  Medicare reassignment NPD Authorized official
• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  NPD (past)

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

• JTC Home Health, Inc.

  • Home Health Agency
  • San Diego, CA
  • NPI 1295306991
  Care Compare affiliation
• Sharp Coronado Hospital and Healthcare Center

  dba Sharp Coronado Hospital

  • General Acute Care Hospital
  • Coronado, CA
  • NPI 1154304475
  Care Compare affiliation
• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  Care Compare affiliation
• Sharp Memorial Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1407839921
  Care Compare affiliation

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1073543781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE B408",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175364",
            "telephone_number": "858-292-8885",
            "fax_number": "858-292-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE B408",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175364",
            "telephone_number": "858-292-8885",
            "fax_number": "858-292-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "GARY",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-11-19",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "G31968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G319680",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "garyboone@sdpcmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "3737 Moraga Ave Ste B408",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921175364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Nicole Bookout, PHARMD
• Heather L. Books, MD
• Chelsea Boomer, DPT
• Amber Lee Boone
• Devon Boone
• Jordan Alexander Boone, PT, DPT
• Joseph Dylan Boone, DO
• NA Kyal Boone
• Theresa Boone, L.AC.
• Victoria Boone

• Adult Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.