Individual provider Active NPI

Blair Boehnke, PA-C

  • Physician Assistant
  • West Des Moines, IA
National Provider Identifier
1245639889
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
075114 Issued in IA
Practice address
6001 Westown Pkwy
West Des Moines, IA 50266-7719
Phone
(515) 224-1414
Fax
(515) 224-5140
NPI assigned
Aug 20, 2014
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 075114 IA Primary

Addresses

Primary practice location

6001 Westown Pkwy
West Des Moines, IA 50266-7719

Mailing address

6001 Westown Pkwy
West Des Moines, IA 50266-7719
Phone (515) 224-1414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140829000977 IA Practitioner - Physician Assistant 3870711039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 60TH St
West Des Moines, IA 50266-7700
Phone (515) 224-5232

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1000

6001 Westown Pkwy
West Des Moines, IA 50266-7702
Phone (515) 224-1414

6001 Westown Pkwy
West Des Moines, IA 50266-7719

Merit-based Incentive Payment System (MIPS)

Final score
72.25 of 100Reported as group
Quality
80.42
Promoting interoperability
39
Improvement activities
40
Cost
77.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
075114IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Des Moines Orthopaedic Surgeons PC CurrentSince Aug 20, 2014 Accepting new patients

Locations

6001 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 224-1414

Interoperability endpoints

  • Direct secure messaging: bboehnke220242@direct.unitypoint.org

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, 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": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1245639889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667719",
            "telephone_number": "515-224-1414",
            "fax_number": "515-224-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667719",
            "telephone_number": "515-224-1414",
            "fax_number": "515-224-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHNKE",
        "first_name": "BLAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "075114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.