Individual provider Active NPI

Megan Jean Boose, PA-C

  • Physician Assistant
  • Fargo, ND
National Provider Identifier
1295069664
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAC0844 Issued in ND
Practice address
3173 43Rd St S Ste a
Fargo, ND 58104-4564
Phone
(701) 478-8780
Fax
(701) 478-8781
NPI assigned
Oct 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00226200 NJ
Physician Assistant 363A00000X PAC0844 ND Primary

Addresses

Primary practice location

3173 43Rd St S Ste a
Fargo, ND 58104-4564

Mailing address

3173 43Rd St S Ste a
Fargo, ND 58104-4564
Phone (701) 478-8780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20200811001067 ND Practitioner - Physician Assistant 4688700966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rachel Ness MD PLLCGroup PAC ID 0749353365, 5 clinicians

Practice addresses (Care Compare)

3173 43Rd St S
Suite a
Fargo, ND 58104-4564
Phone (701) 478-8780

Merit-based Incentive Payment System (MIPS)

Final score
90.27 of 100Reported as group
Quality
86.13
Promoting interoperability
93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAC0844NDMDPhysician Assistant
25MP00226200NJMDPhysician Assistant

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": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1295069664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 43RD ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044564",
            "telephone_number": "701-478-8780",
            "fax_number": "701-478-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3173 43RD ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044564",
            "telephone_number": "701-478-8780",
            "fax_number": "701-478-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOSE",
        "first_name": "MEGAN",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00226200",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.