Peter Boothman, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

M-17515 Issued in ID

Practice address

1618 S Millenium Way Ste 100
Meridian, ID 83642-6457

Phone

(208) 884-3376

Fax

(208) 884-0858

NPI assigned

Apr 20, 2016

Last updated

May 18, 2026By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

University of Washington School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ada West Dermatology, P.C.Group PAC ID 1153341532, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.64 of 100Reported as group

Quality

70.07

Promoting interoperability

100

Improvement activities

40

Cost

55.38

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pboothman@adawest.emadirect.md

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.

• Ada West Dermatology, PC

  • Dermatology Physician
  • Meridian, ID
  • NPI 1518973338
  Medicare reassignment Care Compare group NPD
• Alan J a Pitt MD P a

  • Dermatology Physician
  • Meridian, ID
  • NPI 1154489821
  NPD (past)
• Cutaneous Oncology & Surgery Center, LLC

  dba SmoothRock Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vestavia HLS, AL
  • NPI 1699139915
  NPD (past)

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1588018170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 S MILLENIUM WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S MILLENIUM WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTHMAN",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "ID",
            "license": "M-17515",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AL",
            "license": "MD.36224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pboothman@adawest.emadirect.md",
            "affiliation": "N",
            "address_1": "1618 S Millenium Way Ste 100",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836426457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eva Crucillo Bolivar-Guth
• Brian Bollwitt, D.M.D.
• Brianna Bolton, RRT
• Bonfire Chiropractic PLLC (Bonfire Chiropractic)
• Amber Booth
• Emily Boozalis, MD
• Nicole Danielle Borcyk, OTR/L
• Taylor Jean Borders
• Andrea Bornstein, DMD
• Borron Family Medicine PLLC

• MOHS-Micrographic Surgery Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• MOHS-Micrographic Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.