Mary Lucille Boegel, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

G61295 Issued in CA

Practice address

1455 Montego
#104
Walnut Creek, CA 94598-2990

Phone

(925) 946-1711

Fax

(925) 946-1902

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• West County Health Centers, Inc.

  dba Occidental Area Health Center

  • Federally Qualified Health Center (FQHC)
  • Occidental, CA
  • NPI 1598768962
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339891200000",
    "number": "1437277282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P.O. BOX 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 MONTEGO",
            "address_2": "#104",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982990",
            "telephone_number": "925-946-1711",
            "fax_number": "925-946-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEGEL",
        "first_name": "MARY",
        "middle_name": "LUCILLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "G61295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G612950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Boatright, C.P.
• Hailey Marie Bober
• Eugene D. Bobroff, MD
• Amy Elizabeth Bode
• Bodyplan Institute of Walnut Creek, LLC (Walnut Creek Medical Imaging)
• Jamie Boer
• Christine Boesch
• Amy Boggs
• Leila Bogner, LMFT
• Danielle Bohan, PA-C

• Adult Medicine Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.