Individual provider Active NPI

Jennifer Rose Boozer, DO

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1417067299
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8927 Issued in CA
Practice address
1808 Verdugo Blvd Ste 112
Glendale, CA 91208-1454
Phone
(323) 442-5900
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8927 CA Primary

Addresses

Primary practice location

1808 Verdugo Blvd Ste 112
Glendale, CA 91208-1454

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5900

Other names 1

  • Jennifer Rose Simoneau Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.boozer@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070314000369 CA Practitioner - Family Practice 9830292747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

28780 Single Oak Dr
Suite 160
Temecula, CA 92590-5528
Phone (951) 676-4193

Hospital & facility affiliations

  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8927CAMDFamily Medicine Physician
8927CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Family Medical Group, Inc. Family Medicine CurrentSince Aug 31, 2025 Accepting new patients
Usc Care Medical Group, Inc Family Medicine CurrentSince Mar 3, 2018 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Mar 3, 2018 Accepting new patients

Locations

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

1808 Verdugo Blvd
Ste 112
Glendale, CA 91208
Phone (818) 949-7380

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

38860 Sky Canyon Dr
Bldg A
Murrieta, CA 92563
Phone (442) 777-5920

28780 Single Oak Dr
Ste 160
Temecula, CA 92590
Phone (951) 658-9461

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1417067299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD STE 112",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081454",
            "telephone_number": "323-442-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOZER",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.boozer@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1808 Verdugo Blvd Ste 112",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912081454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SIMONEAU",
            "middle_name": "ROSE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.