NPIMap

Individual provider Active NPI

Keith B Boone, MD

  • Surgery Physician
  • Fresno, CA
National Provider Identifier
1265495139
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G68568 Issued in CA
Practice address
205 E River Park Cir
Suite 460
Fresno, CA 93720-1571
Phone
(559) 261-4500
NPI assigned
Apr 10, 2006
Last updated
Mar 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G68568 CA Primary
Gastroenterology Physician 207RG0100X G68568 CA

Addresses

Primary practice location

205 E River Park Cir
Suite 460
Fresno, CA 93720-1571

Mailing address

PO Box 28947
Fresno, CA 93729-8947
Phone (559) 228-5448

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
I20080124000245 CA Practitioner - General Surgery 0143210013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Southern California Keck School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

205 E River Park Cir
Suite 460
Fresno, CA 93720-1585
Phone (559) 261-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G68568CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Oct 31, 2022 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Valley Surgical Specialists Medical GRP Inc Surgery PastSince May 20, 2002 Accepting new patients

Locations

205 E River Park Cir
Ste 460
Fresno, CA 93720
Phone (559) 261-4500

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Community Regional Medical CenterFresno, CA, CCN 050060 Hospital Corporate Director Jan 1, 2019
Clovis Community Medical CenterClovis, CA, CCN 050492 Hospital Corporate Director Apr 3, 2018
Fresno Community Hospital and Medical CenterFresno, CA, CCN 05T060 Hospital Corporate Director Apr 3, 2018
Community Subacute and Transitional Care CenterFresno, CA, CCN 055258 Skilled nursing facility Corporate Director
Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Jan 1, 2022
Jan 1, 2022
Jan 1, 2022
Jan 1, 2022
Community Home CareFresno, CA, CCN 057248 Home health agency Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 5

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

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.

Hospital & facility affiliations 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1265495139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28947",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298947",
            "telephone_number": "559-228-5448",
            "fax_number": "559-224-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E RIVER PARK CIR",
            "address_2": "SUITE 460",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201571",
            "telephone_number": "559-261-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "KEITH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G68568",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G68568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.