Roger W. Boe, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

M2691 Issued in ID

Practice address

405 W Whitman St
Pocatello, ID 83204-3317

Phone

(208) 233-6833

NPI assigned

Dec 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285797241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S 16TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014003",
            "telephone_number": "208-233-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W WHITMAN ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043317",
            "telephone_number": "208-233-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOE",
        "first_name": "ROGER",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "ID",
            "license": "M2691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BMH, Inc. (Bingham Healthcare Specialty Clinic - Vista)
• BMH, Inc. (1st Choice Urgent Care & Medical Center-Chubbuck)
• BMH, Inc. (Dr. Adam Wray's Dermatology)
• Joel Bocanegra, PHD
• Body & Soul Therapy LLC
• Andrew William Bohnsack, DDS
• Jean M Bokelmann, MD
• Patricia Marion Bolinger, LPC, NCC, NCSC
• Alice D. Bollinger, RN
• Alina Bonci

• Pediatric Adolescent Medicine Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Pediatric Adolescent Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.