Individual provider Active NPI

Peter Edward Boor, M.D.

  • Dermatology Physician
  • Scranton, PA
National Provider Identifier
1366892143
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD469603 Issued in PA
Practice address
327 N Washington Ave Ste 200
Scranton, PA 18503-1535
Phone
(570) 961-5522
NPI assigned
Jun 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD469603 PA Primary

Addresses

Primary practice location

327 N Washington Ave Ste 200
Scranton, PA 18503-1535

Mailing address

327 N Washington Ave Ste 200
Scranton, PA 18503-1535
Phone (570) 961-5522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200721002145 PA Practitioner - Dermatology 4587958103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lackawanna Valley Dermatology Associates LimitedGroup PAC ID 2668459066, 18 clinicians

Practice addresses (Care Compare)

440 Pierce St
Kingston, PA 18704-5500
Phone (570) 287-1122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.11 of 100Reported as group
Quality
96.44
Promoting interoperability
100
Improvement activities
40
Cost
67.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision66
Removal of skin lesions1814
Removal or shaving of skin growth40
Skin biopsy836

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lackawanna Valley Dermatology Associates Limited Dermatology CurrentSince Aug 17, 2020 Accepting new patients

Locations

440 Pierce St
Kingston, PA 18704
Phone (570) 287-1122

327 N Washington Ave
Ste 200
Scranton, PA 18503
Phone (570) 961-5522

327 N Washington Ave
Scranton, PA 18503
Phone (570) 342-4246

Interoperability endpoints

  • Direct secure messaging: pboor@lackaderm.medentdirect.com

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.

Hospital & facility affiliations 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1366892143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N WASHINGTON AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031535",
            "telephone_number": "570-961-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 N WASHINGTON AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031535",
            "telephone_number": "570-961-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOR",
        "first_name": "PETER",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD469603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.