NPIMap

Individual provider Active NPI

Scott M Boles, MD

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1356317747
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G85063 Issued in CA
Practice address
8745 Aero Drive
Suite 200
San Diego, CA 92123-1774
Phone
(858) 565-0950
Fax
(858) 244-1100
NPI assigned
Feb 24, 2006
Last updated
Oct 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X G85063 CA
Neuroradiology Physician 2085N0700X G85063 CA
Nuclear Radiology Physician 2085N0904X G85063 CA
Pediatric Radiology Physician 2085P0229X G85063 CA
Diagnostic Radiology Physician 2085R0202X G85063 CA Primary
Diagnostic Ultrasound Physician 2085U0001X G85063 CA

Addresses

Primary practice location

8745 Aero Drive
Suite 200
San Diego, CA 92123-1774

Mailing address

PO Box 23540
San Diego, CA 92193-3540
Phone (858) 565-0950

Other identifiers 8

IdentifierTypeStateIssuer
GR0083812MedicaidCA
GR0083810MedicaidCA
GR0083813MedicaidCA
GR0083816MedicaidCA
GR0083817MedicaidCA
GR0083811MedicaidCA
GR0083815MedicaidCA
ZZZ75341ZMedicaidCA

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
I20070621000745 CA Practitioner - Diagnostic Radiology 8729187307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Southern California Keck School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Diego Imaging-Chula Vista LLCGroup PAC ID 5496641813, 43 clinicians

Practice addresses (Care Compare)

250 Prospect PL
Coronado, CA 92118-1943
Phone (619) 522-3721

751 Med Ctr CT
Chula Vista, CA 91911-6617
Phone (619) 482-3639

765 Medical Ctr CT
Chula Vista, CA 91911-6600
Phone (619) 397-6577

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3600

7910 Frost St
Suite 100
San Diego, CA 92123-2776
Phone (858) 634-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.75 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.17

Merit-based Incentive Payment System (MIPS)

Final score
90.08 of 100Reported as group
Quality
82.75
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85063CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Diagnostic Radiology Medical Group, Inc. Current Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Aug 28, 2008 Accepting new patients
San Diego Diagnostic Radiology Medical Group Inc Body Imaging Current Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Body Imaging CurrentSince Aug 28, 2008 Accepting new patients
San Diego Imaging-Chula Vista LLC CurrentSince Oct 1, 2003 Accepting new patients
San Diego Imaging, LLC CurrentSince Mar 1, 2023 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
San Diego Diagnostic Radiology Medical Group Inc Body Imaging Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
San Diego Diagnostic Radiology Medical Group, Inc. Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

765 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 397-6577

765 Medical Center Ct
Ste 101
Chula Vista, CA 91911

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3075 Health Center Dr
San Diego, CA 92123
Phone (858) 637-7888

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

7910 Frost St
Ste 100
San Diego, CA 92123
Phone (858) 634-5900

8745 Aero Dr
Ste 200
San Diego, CA 92123

Organizations & group practices 11

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 5

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1356317747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23540",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921933540",
            "telephone_number": "858-565-0950",
            "fax_number": "858-244-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 AERO DRIVE",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231774",
            "telephone_number": "858-565-0950",
            "fax_number": "858-244-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "SCOTT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "G85063",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "G85063",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "G85063",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "G85063",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G85063",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "G85063",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083812",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083810",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083813",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083816",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083817",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083811",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083815",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75341Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.