NPIMap

Individual provider Active NPI

John Anthony Boger, M.D.

  • Gastroenterology Physician
  • Wilkes Barre, PA
National Provider Identifier
1194725515
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD444826 Issued in PA
Practice address
950 E Mountain Blvd
Wilkes Barre, PA 18711-0028
Phone
(570) 808-5780
Fax
(570) 808-5753
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101234774 VA
Gastroenterology Physician 207RG0100X MD444826 PA Primary

Addresses

Primary practice location

950 E Mountain Blvd
Wilkes Barre, PA 18711-0028

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone (570) 808-5780

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jboger101900@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120705000048 PA Practitioner - Gastroenterology 2769647320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Jefferson Medical College of Thomas Jefferson University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone (570) 826-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy94
Upper gastrointestinal (GI) endoscopy for acid reflux94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101234774VAMDInternal Medicine Physician
MD444826PAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jul 1, 2012 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

950 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 808-3290

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: jboger101900@direct.geisinger.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1194725515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110028",
            "telephone_number": "570-808-5780",
            "fax_number": "570-808-5753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Baltimore Dr",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187027900",
            "country_code": "US",
            "telephone_number": "570-808-5780",
            "fax_number": "570-808-5753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGER",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101234774",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD444826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jboger101900@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "675 Baltimore Dr",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187027900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.