NPIMap

Individual provider Active NPI

Jerald P Boseman, MD

  • Nephrology Physician
  • Orem, UT
National Provider Identifier
1801807144
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
5929764-1205 Issued in UT
Practice address
121 S Orem Blvd Ste 103
Orem, UT 84058-3006
Phone
(801) 225-4911
Fax
(801) 225-4854
NPI assigned
Aug 11, 2006
Last updated
May 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 48849 MN
Nephrology Physician 207RN0300X 48108 CO
Nephrology Physician 207RN0300X 5929764-1205 UT Primary

Addresses

Primary practice location

121 S Orem Blvd Ste 103
Orem, UT 84058-3006

Mailing address

121 S Orem Blvd Ste 103
Orem, UT 84058-3006
Phone (801) 225-4911

Other practice location 1

3000 N Triumph Blvd Ste 340
Lehi, UT 84043-7188
Phone (801) 225-4911

Other identifiers 3

IdentifierTypeStateIssuer
055435000MedicaidMN
3007868MedicaidUT
29025354MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jboseman31537@direct.acumenmd.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051104000764 UT Practitioner - NephrologyPractitioner - Internal Medicine 6103844436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Utah School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Utah LLCGroup PAC ID 2769468065, 31 clinicians

Practice addresses (Care Compare)

3702 S State St
Suite 107
S Salt Lake, UT 84115-5096
Phone (801) 288-2634

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48108COMDNephrology Physician
48849MNMDNephrology Physician
5929764-1205UTMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Utah LLC Nephrology CurrentSince Sep 1, 2018 Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology PastSince Sep 20, 2020 Accepting new patients

Locations

3000 N Triumph Blvd
Ste 340
Lehi, UT 84043
Phone (801) 225-4911

121 S Orem Blvd
Ste 103
Orem, UT 84058
Phone (801) 225-4911

12523 S Creek Meadow Rd
Ste 111
Riverton, UT 84065
Phone (801) 288-2634

3702 S State St
Ste 107
South Salt Lake, UT 84115
Phone (801) 288-2634

2965 W 3500 S
Fl 2
West Valley City, UT 84119
Phone (801) 288-2634

4101 W Pioneer Pkwy
Ste 103
West Valley City, UT 84120
Phone (801) 288-2634

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14360/brand/23/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHACA
  • Direct secure messaging: jboseman31537@direct.acumenmd.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1801807144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S OREM BLVD STE 103",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840583006",
            "telephone_number": "801-225-4911",
            "fax_number": "801-225-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S OREM BLVD STE 103",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840583006",
            "telephone_number": "801-225-4911",
            "fax_number": "801-225-4854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 N Triumph Blvd Ste 340",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840437188",
            "country_code": "US",
            "telephone_number": "801-225-4911",
            "fax_number": "801-225-4854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSEMAN",
        "first_name": "JERALD",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "48849",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "48108",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "5929764-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055435000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007868",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29025354",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jboseman31537@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "121 S Orem Blvd Ste 103",
            "city": "Orem",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840583006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.