Jerald P Boseman, MD
Individual provider Active NPI Nephrology Physician · Orem, UT
NPI 1801807144 · NPPES record last updated May 2, 2024
Key facts
- NPI
- 1801807144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 5929764-1205 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nephrology
- 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 LLC
Practice addresses (Care Compare)
3702 S State St
Suite 107
S Salt Lake, UT 84115-5096
Phone (801) 288-2634
Hospital & facility affiliations
- 462552-Fresenius Kidney Care Utah Valley
- DaVita Utah Valley Dialysis Center
- Intermountain Health Utah Valley Hospital
- American Fork Hospital
- Holy Cross Hospital-Jordan Valley
- Orem Community Hospital
- Intermountain Health Sanpete Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051104000764 | UT | Practitioner - Nephrology |
6103844436 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48108 | CO | MD | Nephrology Physician |
| 5929764-1205 | UT | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology Associates of Utah LLC | Nephrology | Current |
Accepting new patients |
| Western Nephrology & Metabolic Bone Disease, P.C. | Nephrology | Past |
Accepting new patients |
Locations
3000 N Triumph Blvd
Ste 340
Lehi, UT 84043
Phone (435) 833-9180
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 203
South Salt Lake, UT 84115
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
- jboseman31537@direct.acumenmd.com
- https://api.platform.athenahealth.com/14360/brand/23/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/ACHACA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 48849 | MN | |
| Nephrology Physician | 207RN0300X | 48108 | CO | |
| Nephrology Physician | 207RN0300X | 5929764-1205 | UT | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29025354 | Medicaid | CO | |
| 3007868 | Medicaid | UT | |
| 055435000 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jboseman31537@direct.acumenmd.com |
Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.