Individual provider Active NPI

Blair Edward Boehmer, M.D.

  • Ophthalmology Physician
  • Indianapolis, IN
National Provider Identifier
1134313638
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01069880A Issued in IN
Practice address
10610 N Pennsylvania St
Indianapolis, IN 46280-2004
Phone
(317) 844-6269
Fax
(317) 815-7567
NPI assigned
Aug 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01069880A IN Primary

Addresses

Primary practice location

10610 N Pennsylvania St
Indianapolis, IN 46280-2004

Mailing address

421 Canal View Cir
Apt K
Indianapolis, IN 46202-6141
Phone (317) 844-6269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20110809000345 IN Practitioner - Ophthalmology 4082883095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Indiana University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pankratz Medical LLCGroup PAC ID 3870864283, 2 clinicians

Practice addresses (Care Compare)

3135 Middle Dr
Columbus, IN 47203-4472
Phone (812) 373-7777

Hospital & facility affiliations

  • Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112

Merit-based Incentive Payment System (MIPS)

Final score
86.81 of 100Reported as group
Quality
100
Improvement activities
40
Cost
56.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery260

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pankratz Medical LLC Ophthalmology CurrentSince Sep 1, 2019 Accepting new patients
Major Hospital Ophthalmology Past Accepting new patients

Locations

3135 Middle Rd
Columbus, IN 47203
Phone (812) 373-7777

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1134313638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 CANAL VIEW CIR",
            "address_2": "APT K",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462026141",
            "telephone_number": "317-844-6269",
            "fax_number": "317-815-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 N PENNSYLVANIA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802004",
            "telephone_number": "317-844-6269",
            "fax_number": "317-815-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHMER",
        "first_name": "BLAIR",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01069880A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.