NPIMap

Individual provider Active NPI

Brian S Boe, M.D.

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1124049473
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036086371 Issued in IL
Practice address
1100 W Cermak Rd
Suite C119
Chicago, IL 60608-4500
Phone
(312) 243-2223
Fax
(312) 243-2227
NPI assigned
Jul 22, 2006
Last updated
May 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036086371 IL Primary

Addresses

Primary practice location

1100 W Cermak Rd
Suite C119
Chicago, IL 60608-4500

Mailing address

1100 W Cermak Rd
Suite C119
Chicago, IL 60608-4500
Phone (312) 243-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707000137 IL Practitioner - Internal MedicinePractitioner - General Surgery 9032155452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD @ Home Illinois, SCGroup PAC ID 7810167830, 53 clinicians

Practice addresses (Care Compare)

2003 W Fulton St
Suite 303
Chicago, IL 60612-2345
Phone (312) 243-2223

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.62 of 100Reported as group
Quality
64.25
Promoting interoperability
95
Improvement activities
40
Cost
41.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036086371ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MD @ Home Illinois, SC CurrentSince Jul 15, 2011 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Minimally Invasive Therapy Specialists SC Past Accepting new patients

Locations

1100 W Cermak Rd
Ste C119
Chicago, IL 60608
Phone (312) 243-2223

2003 W Fulton St
Ste 303
Chicago, IL 60612
Phone (312) 243-2223

Interoperability endpoints

  • Direct secure messaging: brian.boe.1@3342.direct.athenahealth.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.

Hospital & facility affiliations 8

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1124049473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W CERMAK RD",
            "address_2": "SUITE C119",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084500",
            "telephone_number": "312-243-2223",
            "fax_number": "312-243-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W CERMAK RD",
            "address_2": "SUITE C119",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084500",
            "telephone_number": "312-243-2223",
            "fax_number": "312-243-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOE",
        "first_name": "BRIAN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036086371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.