Michael H. De Boer, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

19872 Issued in TN

Practice address

9352 Park West Blvd
Knoxville, TN 37923-4325

Phone

(865) 373-1000

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  KY, TN

  Medicare reassignment Care Compare group
• Afc Physicians of Tennessee, PC

  • Primary Care Clinic/Center
  • Chattanooga, TN
  • NPI 1114234523

  TN

  Medicare reassignment NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine, TN

  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  KY

  Medicare reassignment NPD
• Kentucky Post-Acute Medical Services 1 PSC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Flemingsburg, KY
  • NPI 1831628783

  KY

  Medicare reassignment NPD
• T J Samson Community Hospital

  • Family Medicine Physician
  • Glasgow, KY
  • NPI 1477609865

  KY

  Medicare reassignment NPD
• Urgent Care Services Southeast PSC

  • Family Medicine Physician
  • Glasgow, KY
  • NPI 1427831759

  KY

  Medicare reassignment NPD
• Afc Physicians of Tennessee, PC

  • General Practice Physician
  • Knoxville, TN
  • NPI 1649647249
  NPD
• Ky-I Medical Services, P.S.C.

  • Physician Assistant
  • Frankfort, KY
  • NPI 1336586932
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bowling Green-Warren County Community Hospital Corporation

  • Critical Access Hospital
  • Scottsville, KY
  • NPI 1710906565

  Hospital

  Care Compare affiliation
• Bowling Green-Warren County Community Hospital Corporation

  • Critical Access Hospital
  • Franklin, KY
  • NPI 1831173467

  Hospital

  Care Compare affiliation

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Texas Medical Branch at Galveston, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLC 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center at Scottsville Hospital, Scottsville, KY, CCN 181324
• The Medical Center at Franklin Hospital, Franklin, KY, CCN 181318

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 10, 2023.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1780624809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984",
            "telephone_number": "865-693-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9352 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234325",
            "telephone_number": "865-373-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 N L Rogers Wells Blvd",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421411300",
            "country_code": "US",
            "telephone_number": "270-659-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE BOER",
        "first_name": "MICHAEL",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "46604",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "19872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRGA",
            "identifier": "930005254",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4091370",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64043011",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096096",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Dayer
• Dayspring Family Care PLLC
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• Dba: Dolly Parton Children'S Hospital Cardiology
• DBLK Sports & Wellness Management
• Samantha De Gannes, MD
• Abigail De Guzman, D.O.
• Enrique Adrian De Jesus Jr.
• Sandra Esther De Jesus, LMT, RCR
• Stuart Joseph Deaderick, M.D.

• All providers in Knoxville, TN
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.