NPIMap

Individual provider Active NPI

Brock Eugene Boehm, D.O.

  • Urology Physician
  • Denver, CO
National Provider Identifier
1700299773
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
DR.0071211 Issued in CO
Practice address
777 Bannock St # Mc3240
Denver, CO 80204-4597
Phone
(303) 436-6000
NPI assigned
Jun 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0102204301 VA
General Practice Physician 208D00000X 0102204301 VA
Urology Physician 208800000X DR.0071211 CO Primary

Addresses

Primary practice location

777 Bannock St # Mc3240
Denver, CO 80204-4597

Mailing address

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Other practice location 1

36000 Darnall Loop
Carl R. Darnall Army Medical Center
Fort Hood, TX 76544
Phone (254) 288-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230628001038 CO Practitioner - Urology 2466679766 Reassigns benefits to 1 organization
I20240709003981 WA Practitioner - Urology 2466679766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Public Hospital District No 2 Skagit County WashingtonGroup PAC ID 1153225198, 77 clinicians

Practice addresses (Care Compare)

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1350

Hospital & facility affiliations

  • Island Hospital Hospital, Anacortes, WA, CCN 500007
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339
  • Peacehealth Peace Island Medical Center Hospital, Friday Harbor, WA, CCN 501340
  • Peacehealth United General Medical Center Hospital, Sedro Woolley, WA, CCN 501329

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0071211COMDUrology Physician
0102204301VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jun 20, 2023 Accepting new patients
Public Hospital District No 2 Skagit County Washington CurrentSince Jul 1, 2024 Accepting new patients
Public Hospital District No 2 Skagit County Washington Current Accepting new patients
Public Hospital District No 2 Skagit County Washington CurrentSince Jul 1, 2024 Accepting new patients
Denver Health and Hospital Authority General Practice CurrentSince Jun 20, 2023 Accepting new patients
Public Hospital District No 2 Skagit County Washington Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

1110 22nd St
Anacortes, WA 98221
Phone (360) 293-3101

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

Interoperability endpoints

  • Direct secure messaging: bboehm280732@direct.dhha.org

Organizations & group practices 6

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 10

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": "1402185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1700299773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC3240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36000 Darnall Loop",
            "address_2": "Carl R. Darnall Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "76544",
            "country_code": "US",
            "telephone_number": "254-288-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEHM",
        "first_name": "BROCK",
        "middle_name": "EUGENE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-08",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0102204301",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102204301",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CO",
            "license": "DR.0071211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.