Individual provider Active NPI

Marshall Alan Boose, D.O.

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1639610223
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5101026652 Issued in MI
Practice address
1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone
(616) 459-7101
Fax
(616) 464-6170
NPI assigned
Mar 15, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101026652 MI Primary

Addresses

Primary practice location

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406

Mailing address

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220608001855 MI Practitioner - Orthopedic Surgery 7517345275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
West Virginia University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Associates of Grand Rapids PCGroup PAC ID 9537136403, 86 clinicians

Practice addresses (Care Compare)

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 774-7444

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

  • Corewell Health Visiting Nurse Association Home health agency, Grand Rapids, MI, CCN 237007
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
49.04
Promoting interoperability
96
Improvement activities
40
Cost
82.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Grand Rapids, PC Orthopaedic Surgery CurrentSince Jul 18, 2022 Accepting new patients
Orthopaedic Associates of Grand Rapids PC Orthopaedic Surgery CurrentSince Jul 18, 2022 Accepting new patients
Sheridan Community Hospital Past Accepting new patients

Locations

1111 Leffingwell Ave NE
Grand Rapids, MI 49525
Phone 61645971011381

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone 61645971011381

Interoperability endpoints

  • Direct secure messaging: mboose65380@direct.metrohealth.net
  • Direct secure messaging: marshall.boose.p1@direct.oam.nextgenshare.com

Organizations & group practices 7

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 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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1639610223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101",
            "fax_number": "616-464-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101",
            "fax_number": "616-464-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOSE",
        "first_name": "MARSHALL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101026652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.