NPIMap

Individual provider Active NPI

Austin J Boeckman, DO

  • Family Medicine Physician
  • Guthrie Center, IA
National Provider Identifier
1417515685
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-11604 Issued in IA
Practice address
710 N 12TH St
Guthrie Center, IA 50115-1549
Phone
(641) 332-2201
Fax
(641) 332-3856
NPI assigned
Jun 3, 2019
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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 R-11604 IA Primary

Addresses

Primary practice location

710 N 12TH St
Guthrie Center, IA 50115-1549

Mailing address

710 N 12TH St
Guthrie Center, IA 50115-1549
Phone (641) 332-2201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20220730000429 IA Practitioner - Family Practice 0840672333 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie County HospitalGroup PAC ID 6204745110, 16 clinicians

Practice addresses (Care Compare)

312 N Fremont St B
Stuart Rehab Clinic
Stuart, IA 50250-2083
Phone (515) 523-8049

710 N 12TH St
Guthrie Center, IA 50115-1549
Phone (641) 332-2201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-11604IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Guthrie County Hospital CurrentSince Sep 6, 2022 Accepting new patients
Guthrie County Hospital Family Medicine CurrentSince Sep 6, 2022 Accepting new patients

Locations

710 N 12th St
Guthrie Ctr, IA 50115
Phone (641) 332-2201

312 N Fremont St
Ste A
Stuart, IA 50250
Phone (515) 523-8050

Interoperability endpoints

  • Direct secure messaging: aboeckman582625@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Guthrie County HospitalGuthrie Center, IA, CCN 161314 Hospital W-2 Managing Employee
Operational/Managerial Control		 Jan 1, 2025
Jan 1, 2025
Guthrie County HospitalGuthrie Center, IA, CCN 16Z314 Hospital W-2 Managing Employee
Operational/Managerial Control		 Jan 1, 2025
Jan 1, 2025
GCH ClinicsAdair, IA, CCN 168620 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Jul 17, 2023
Jul 17, 2023
GCH ClinicsStuart, IA, CCN 168632 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Aug 12, 2024
Aug 12, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1417515685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N 12TH ST",
            "city": "GUTHRIE CENTER",
            "state": "IA",
            "postal_code": "501151549",
            "telephone_number": "641-332-2201",
            "fax_number": "641-332-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N 12TH ST",
            "city": "GUTHRIE CENTER",
            "state": "IA",
            "postal_code": "501151549",
            "telephone_number": "641-332-2201",
            "fax_number": "641-332-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOECKMAN",
        "first_name": "AUSTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-11604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie Center, IA

Sources for this page

Verify at the official NPI Registry.