Individual provider Active NPI

Brian James Boerma, M.A

  • Professional Counselor
  • Baker City, OR
National Provider Identifier
1235335290
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C5728 Issued in OR
Practice address
3425 13TH St
Baker City, OR 97814-1340
Phone
(541) 523-7400
Fax
(541) 523-4927
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401010452 MI
Professional Counselor 101YP2500X C5728 OR Primary

Addresses

Primary practice location

3425 13TH St
Baker City, OR 97814-1340

Mailing address

3425 13TH St
Baker City, OR 97814-1340
Phone (541) 523-7400

Other identifiers 2

IdentifierTypeStateIssuer
500794921MedicaidOR
B176375OtherORODL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317003448 OR Practitioner - Other (Non-Physician) 2163906280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3425 13TH St
Baker City, OR 97814-1340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401010452MIMDProfessional Counselor
C5728ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions Northwest, Inc CurrentSince Mar 2, 2026 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1235335290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERMA",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "M.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010452",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500794921",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODL",
            "identifier": "B176375",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker City, OR

Sources for this page

Verify at the official NPI Registry.