Individual provider Active NPI

Brock Boscovich, MD

  • Emergency Medicine Physician
  • Reno, NV
National Provider Identifier
1689658270
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11916 Issued in NV
Practice address
235 W 6TH St
Reno, NV 89503-4548
Phone
(775) 746-3202
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11916 NV Primary

Addresses

Primary practice location

235 W 6TH St
Reno, NV 89503-4548

Mailing address

235 W 6TH St
Reno, NV 89503-4548
Phone (775) 746-3202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20070205000130 NV Practitioner - Emergency Medicine 2668494758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nevada School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carson Tahoe Emergency PhysiciansGroup PAC ID 7416930573, 17 clinicians
Reno Emergency Physicians Association PLLCGroup PAC ID 6305745738, 13 clinicians

Practice addresses (Care Compare)

1600 Medical Pkwy
Carson City, NV 89703-4625
Phone (775) 445-8000

235 W 6TH St
Reno, NV 89503-4548
Phone (775) 770-5188

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11916NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Tahoe Emergency Physicians Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Reno Emergency Physicians Association, PLLC Emergency Medicine CurrentSince Apr 19, 2009 Accepting new patients
CTH Physicians Clinic Past Accepting new patients

Locations

775 Fleischmann Way
Carson City, NV 89703
Phone (775) 445-5632

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

235 W 6th St
Reno, NV 89503
Phone (775) 746-3202

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 5

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1689658270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 W 6TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034548",
            "telephone_number": "775-746-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W 6TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034548",
            "telephone_number": "775-746-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCOVICH",
        "first_name": "BROCK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "11916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.