Individual provider Active NPI

Katherine Boehm, DO

  • Sports Medicine (Family Medicine) Physician
  • San Diego, CA
National Provider Identifier
1497375232
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A20113 Issued in CA
Practice address
6699 Alvarado Rd
Suite 2100
San Diego, CA 92120
Phone
(619) 229-3909
NPI assigned
Apr 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 20A20113 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120

Mailing address

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120
Phone (619) 229-3909

Other practice location 1

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 948-5672

Other practice location 2

2800 E Ajo Way Ste 200
Tucson, AZ 85713-6204
Phone (520) 694-8000

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
I20240927002382 CA Practitioner - Family Practice 1658766621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SD Sports Medicine and Family Health CenterGroup PAC ID 7113812496, 38 clinicians

Practice addresses (Care Compare)

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120-5238
Phone (619) 229-3909

Hospital & facility affiliations

  • Arc Health Systems LLC Home health agency, San Diego, CA, CCN 757877
  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.4 of 100Reported as group
Quality
93.75
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1364CAMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
SD Sports Medicine and Family Health Center CurrentSince Sep 16, 2024 Accepting new patients
Banner-University Medical Group Family Medicine PastSince Jun 1, 2023 Accepting new patients
Regents of the University of California Family Medicine Past Accepting new patients

Locations

6699 Alvarado Rd
Ste 2100
San Diego, CA 92120
Phone (619) 229-3909

6699 Alvarado Rd
Ste 101
San Diego, CA 92120

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 2

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1497375232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD",
            "address_2": "SUITE 2100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-229-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD",
            "address_2": "SUITE 2100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92120",
            "telephone_number": "619-229-3909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 N Brent St",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930032809",
            "country_code": "US",
            "telephone_number": "805-948-5672",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 E Ajo Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136204",
            "country_code": "US",
            "telephone_number": "520-694-8000",
            "fax_number": "520-874-9001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "KATHERINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A20113",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.