Individual provider Active NPI

Matthew Joseph Boren, D.O.

  • Emergency Medicine Physician
  • Aberdeen Proving Ground, MD
National Provider Identifier
1801939384
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A11375 Issued in CA
Practice address
2501 Oakington St
Aberdeen Proving Ground, MD 21005-5131
Phone
(410) 278-1967
Fax
(410) 278-1957
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X H0065579 MD
Emergency Medicine Physician 207P00000X 20A11375 CA Primary

Addresses

Primary practice location

2501 Oakington St
Aberdeen Proving Ground, MD 21005-5131

Mailing address

2501 Oakington St
Aberdeen Proving Ground, MD 21005-5131
Phone (410) 278-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101203000033 CA Practitioner - Emergency Medicine 5890857700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0065579MDMDEmergency Medicine Physician
11375CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients
Georgia Emergency Associates Emergency Medicine Past Accepting new patients

Locations

2000 Sutter Pl
Davis, CA 95616
Phone (530) 756-6440

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2801 L St
Sacramento, CA 95816
Phone (916) 454-2222

Interoperability endpoints

  • Direct secure messaging: mboren20313@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1801939384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 OAKINGTON ST",
            "city": "ABERDEEN PROVING GROUND",
            "state": "MD",
            "postal_code": "210055131",
            "telephone_number": "410-278-1967",
            "fax_number": "410-278-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 OAKINGTON ST",
            "city": "ABERDEEN PROVING GROUND",
            "state": "MD",
            "postal_code": "210055131",
            "telephone_number": "410-278-1967",
            "fax_number": "410-278-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "H0065579",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A11375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen Proving Ground, MD

Sources for this page

Verify at the official NPI Registry.