Geoffrey Keith Boercker, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD00026779 Issued in WA

Practice address

1050 Larrabee Ave
#104-PMB 317
Bellingham, WA 98225-7367

Phone

(360) 220-1744

NPI assigned

Apr 12, 2012

Last updated

Nov 9, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1457618662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 BASS ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982298836",
            "telephone_number": "360-220-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LARRABEE AVE",
            "address_2": "#104-PMB 317",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257367",
            "telephone_number": "360-220-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERCKER",
        "first_name": "GEOFFREY",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "WA",
            "license": "MD00026779",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00026779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1102243",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0116494",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simme Bobrosky, B.S.
• James J. Bochsler, M.D.
• Elizabeth Katharine Bodner, ARNP, CNM
• Judith Melaine Bodner, LMP
• Body Reflections, PLLC
• Christy Boex, MS, LMHC
• Randy J. Bogard, DMD, MD
• Stephen Bogert, L AC, CH
• Christian Oliver Bohan, MD
• Juliana K. Bohn, PT

• Psychiatry Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.