Elizabeth Ann Boehme, PA-C
Individual provider Active NPI Physician Assistant · Dublin, VA
NPI 1154894210 · NPPES record last updated Dec 10, 2020
Key facts
- NPI
- 1154894210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110006512 (VA)
- Practice address
- Dublin Family Medicine
118 Broad St.
Dublin, VA 24084-3211 - Phone
- (540) 674-8805
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grant Memorial Hospital Inc
Practice addresses (Care Compare)
10 Mulligan Dr
Petersburg, WV 26847-1000
Phone (304) 257-5013
117 Hospital Dr
Petersburg, WV 26847-9566
Phone (304) 257-1026
Hospital & facility affiliations
- Grant Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.34 of 100
- Quality
- 79.86
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221215000956 | MD | Practitioner - Physician Assistant | 4789925470 | |
| I20250407003076 | WV | Practitioner - Physician Assistant | 4789925470 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2967 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grant Memorial Hospital Inc | Current |
Accepting new patients |
Locations
117 Hospital Dr
Petersburg, WV 26847
Phone 30497450009312
Interoperability endpoints
- eboehme330554@direct.wvuhsdirect.com
- eboehme79698@direct.carilionclinic.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110006512 | VA | Yes |
Addresses
Primary practice location
Dublin Family Medicine
118 Broad St.
Dublin, VA 24084-3211
Mailing address
351 Rolling Hills Dr
Christiansburg, VA 24073-6037
Phone (314) 210-2302
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eboehme79698@direct.carilionclinic.org | Direct |
Other providers in Dublin, VA
- April Loving Andrews
- Charles Samuel Averette
- Melinda Lynn Barber
- Kristin Anne Berke
- Charles Eric Berry
- Ashley Nicole Boyd
- Scott Robert Brandau
- Kelsey Lee Brimer
- Teresa Brookman
- Rita Price Burdette
All providers in Dublin, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.