Individual provider Active NPI

John Bredin Boggs, ACNP

  • Acute Care Nurse Practitioner
  • Santa Cruz, CA
National Provider Identifier
1679919138
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
22924 Issued in CA
Practice address
1661 Soquel Dr Ste D
Santa Cruz, CA 95065-1709
Phone
(831) 460-6041
NPI assigned
May 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 22924 CA Primary

Addresses

Primary practice location

1661 Soquel Dr Ste D
Santa Cruz, CA 95065-1709

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160902001610 CA Practitioner - Nurse Practitioner 4688960495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1661 Soquel Dr
Suite D
Santa Cruz, CA 95065-1709
Phone (831) 460-6041

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22924CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Dec 1, 2019 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Dec 1, 2019 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

1661 Soquel Dr
Ste F
Santa Cruz, CA 95065
Phone (408) 476-8900

1661 Soquel Dr
Ste D
Santa Cruz, CA 95065
Phone (831) 458-6925

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: jboggs534494@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 1

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": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1679919138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 SOQUEL DR STE D",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651709",
            "telephone_number": "831-460-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "JOHN",
        "middle_name": "BREDIN",
        "name_prefix": "Mr.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "22924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.