Individual provider Active NPI

William Lee Boren, M.D.

  • Diagnostic Radiology Physician
  • Las Vegas, NV
National Provider Identifier
1811091192
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6453 Issued in NV
Practice address
3025 S Rainbow Blvd
Las Vegas, NV 89146-6582
Phone
(702) 222-3544
Fax
(702) 889-0422
NPI assigned
Sep 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 6453 NV Primary

Addresses

Primary practice location

3025 S Rainbow Blvd
Las Vegas, NV 89146-6582

Mailing address

3025 S Rainbow Blvd
Las Vegas, NV 89146-6582
Phone (702) 222-3544

Other identifiers 1

IdentifierTypeStateIssuer
2019306MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6453NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Health Corporation Past Accepting new patients

Organizations & group practices 1

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1811091192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466582",
            "telephone_number": "702-222-3544",
            "fax_number": "702-889-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466582",
            "telephone_number": "702-222-3544",
            "fax_number": "702-889-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREN",
        "first_name": "WILLIAM",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "6453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019306",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.