Carolin Anne Boecking, M.D.

Primary specialty

Forensic Pathology PhysicianTaxonomy code 207ZF0201X

License

S-21-314 Issued in MI

Practice address

850 Thornton Way
San Jose, CA 95128-4702

Phone

(408) 793-1900

NPI assigned

Mar 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1780046441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 THORNTON WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284702",
            "telephone_number": "408-793-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 THORNTON WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284702",
            "telephone_number": "408-793-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOECKING",
        "first_name": "CAROLIN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MI",
            "license": "20-018",
            "primary": false
        },
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "MI",
            "license": "S-21-314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Jordan Boddie-Russo, LCSW
• Priyanka Boddu
• Devi Prathyusha Bodduri
• David William Bodine
• Shannon Nicole Boe
• Katherine Boeckman, ASW
• Tyler Boedeker
• Ashely Michelle Boek
• Debra Boethling
• Sophia Boettcher, BSCS, NC, MT, DD

• Forensic Pathology Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Forensic Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.