Adam Keith Boettcher, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301090356 Issued in MI

Practice address

1020 N San Francisco St Ste 200
Flagstaff, AZ 86001-3281

Phone

(928) 774-2300

NPI assigned

Jun 26, 2007

Last updated

Jan 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Plastic and Reconstructive SurgeryAlso: Hand Surgery

Education

University of Minnesota Medical School, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plastic Surgeons of Northern Arizona P L L CGroup PAC ID 8224922182, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012
• Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Plastic Surgeons of Northern Arizona, PLLC

  • Specialist
  • Flagstaff, AZ
  • NPI 1871531418

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552

  Multi-Specialty

  Medicare reassignment NPD
• Northern Arizona Healthcare Corporation

  dba Northern Arizona Healthcare Children's Health Center

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD
• Northern Arizona Surgicenter, LLC

  • Ambulatory Surgical Clinic/Center
  • Flagstaff, AZ
  • NPI 1871596114
  NPD
• Plastic Surgeons of Northern Arizona, PLLC

  • Plastic Surgery Physician
  • Flagstaff, AZ
  • NPI 1154511814

  Multi-Specialty

  NPD
• Northern Arizona Healthcare Corporation

  dba Northern Arizona Healthcare Children's Health Center

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1164104642
  NPD (past)

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

• Flagstaff Medical Center

  dba Guardian Air

  • Air Ambulance
  • Flagstaff, AZ
  • NPI 1427234111

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  dba Guardian Medical Transport

  • Land Ambulance
  • Flagstaff, AZ
  • NPI 1518143205

  Hospital

  Care Compare affiliation
• Flagstaff Medical Center

  dba FMC Behavioral Health Services

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
  • NPI 1649370875
  Care Compare affiliation
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  Care Compare affiliation
• Verde Valley Medical Center

  • General Acute Care Hospital
  • Cottonwood, AZ
  • NPI 1346291648
  Care Compare affiliation
• Verde Valley Medical Center

  dba Northern Arizona Healthcare - Sedona

  • General Acute Care Hospital
  • Sedona, AZ
  • NPI 1538608716
  Care Compare affiliation
• Yavapai Community Hospital Association

  dba Yavapai Regional Medical Center

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1134325012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST STE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-774-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST STE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "928-774-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Monroe Ave NW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495031455",
            "country_code": "US",
            "telephone_number": "616-732-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOETTCHER",
        "first_name": "ADAM",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301090356",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "45896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P707631",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akboettcher@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1020 N San Francisco St Ste 200",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860013281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akboetther@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "direct message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1020 N San Francisco St Ste 200",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860013281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ruth Blair
• Teresa Block, RN
• Blue Gems ABA Az LLC
• Darren Blue
• Deborah Bodin, P.T., M.P.T.
• Shannon Lyons Boffeli, APRN
• Audrey Bohlmann
• James Dean Bohn, CRNA
• Nadine Bohn, RDH
• Bolt Ons (Next Step Prosthetics)

• Surgery Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.