NPIMap

Individual provider Active NPI

Sheryl J Boon, MD

  • Pediatric Rheumatology Physician
  • Tacoma, WA
National Provider Identifier
1174613244
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
MD60628779 Issued in WA
Practice address
311 S L St
Tacoma, WA 98405-3720
Phone
(253) 403-1420
NPI assigned
Oct 13, 2006
Last updated
May 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X A61747 CA
Pediatric Rheumatology Physician 2080P0216X MD2014-0891 NM
Pediatric Rheumatology Physician 2080P0216X MD60628779 WA Primary

Addresses

Primary practice location

311 S L St
Tacoma, WA 98405-3720

Mailing address

311 S L St
Tacoma, WA 98405-3720
Phone (253) 403-1420

Other identifiers 1

IdentifierTypeStateIssuer
00A617470MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160429001038 WA Practitioner - Pediatric Medicine 8325362288 Reassigns benefits to 1 organization
I20220325000491 CA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 8325362288 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61747CAMDPediatric Rheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Multicare Health System CurrentSince May 1, 2016 Accepting new patients
Regents of the University of Ca CurrentSince Mar 28, 2022 Accepting new patients
Multicare Health System CurrentSince May 1, 2016 Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 28, 2022 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients

Locations

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2521 Stockton Blvd
Ste 3200
Sacramento, CA 95817
Phone (916) 734-3112

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: sboon222249@direct.multicare.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1174613244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S L ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053720",
            "telephone_number": "253-403-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S L ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053720",
            "telephone_number": "253-403-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOON",
        "first_name": "SHERYL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "CA",
            "license": "A61747",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "NM",
            "license": "MD2014-0891",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "WA",
            "license": "MD60628779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A617470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.