NPIMap

Individual provider Active NPI

Michael J. Boyers, MD

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1235213307
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A80391 Issued in CA
Practice address
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone
(707) 571-4000
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A80391 CA Primary

Addresses

Primary practice location

401 Bicentennial Way
Santa Rosa, CA 95403-2149

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A803910MedicaidCA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mboyers1657513@oc.providencedirect.org
Direct Messaging Address mboyers1657513@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101129000303 CA Practitioner - Family Practice 7416143763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

8911 Lakewood Dr
Suite 13
Windsor, CA 95492-7857
Phone (707) 387-3910

Hospital & facility affiliations

  • Providence at Home With Compassus Home Health, Sonoma Home health agency, Santa Rosa, CA, CCN 557433
  • Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
  • Accentcare Home Health of California, Inc Home health agency, San Ramon, CA, CCN 057517
  • Gateway Home Health Corp. Home health agency, San Ramon, CA, CCN 053129
  • Bridge Home Health Home health agency, Petaluma, CA, CCN 559097
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • Healdsburg Hospital Hospital, Healdsburg, CA, CCN 051321

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A80391CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Family Medicine CurrentSince Jun 20, 2016 Accepting new patients
Providence Medical Foundation CurrentSince Jun 20, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

2323 Bethards Dr
Santa Rosa, CA 95405
Phone (707) 542-1611

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

8911 Lakewood Dr
Ste 13
Windsor, CA 95492
Phone (707) 387-3910

Interoperability endpoints

  • Direct secure messaging: mboyers1657513@oc.providencedirect.org

Organizations & group practices 5

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 8

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1235213307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "707-571-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYERS",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A80391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A803910",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboyers1657513@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "8911 Lakewood Dr Ste 13",
            "city": "Windsor",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954927857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboyers1657513@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2323 Bethards Dr",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954058500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.