Individual provider Active NPI

Thomas Joseph Boo, MD

  • Family Medicine Physician
  • Bishop, CA
National Provider Identifier
1255664124
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G80249 Issued in CA
Practice address
153 Pioneer LN Ste B
Bishop, CA 93514-2517
Phone
(760) 873-2849
Fax
(760) 873-2836
NPI assigned
Sep 10, 2009
Last updated
Jan 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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 G80249 CA Primary

Addresses

Primary practice location

153 Pioneer LN Ste B
Bishop, CA 93514-2517

Mailing address

PO Box 275
Bishop, CA 93515-0275
Phone (760) 873-2849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000202 CA Practitioner - Family Practice 7012042765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians

Practice addresses (Care Compare)

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

150 Pioneer LN
Bishop, CA 93514-2599

152 Pioneer LN
Bishop, CA 93514-2563

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80249CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Inyo Healthcare District CurrentSince Dec 15, 2010 Accepting new patients
Northern Inyo Healthcare District CurrentSince Dec 15, 2010 Accepting new patients
Northern Inyo Healthcare District PastSince May 4, 2025 Accepting new patients
Stacey L. Brown, M.D. Family Medicine Past Accepting new patients

Locations

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

153 Pioneer Ln
Ste B
Bishop, CA 93514
Phone (760) 873-2602

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice of the Owen ValleyBishop, CA, CCN 557008 Home health agency Corporate Director Apr 27, 2013
Hospice of the Owens ValleyBishop, CA, CCN 921591 Hospice Corporate Director Apr 27, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1255664124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 275",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935150275",
            "telephone_number": "760-873-2849",
            "fax_number": "760-873-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 PIONEER LN STE B",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142517",
            "telephone_number": "760-873-2849",
            "fax_number": "760-873-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOO",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-10",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G80249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

Verify at the official NPI Registry.