Roger Melvin Boettcher, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28490 Issued in MN

Practice address

200 Elm St N
Onamia, MN 56359-7901

Phone

(320) 532-3154

Fax

(320) 532-3111

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rboettch@yourcarecommunity.org

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.

• Mille Lacs Health System

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699
  Medicare reassignment NPD
• Unity Family Healthcare

  • Orthopaedic Surgery Physician
  • Little Falls, MN
  • NPI 1326234006
  Medicare reassignment NPD
• Unity Family Healthcare

  • Critical Access Hospital
  • Little Falls, MN
  • NPI 1780630939
  Medicare reassignment NPD
• Mille Lacs Health System

  • Community/Retail Pharmacy
  • Onamia, MN
  • NPI 1841947801
  NPD
• Mille Lacs Health System

  • Psychiatric Hospital Unit
  • Onamia, MN
  • NPI 1972763001
  NPD
• Unity Family Healthcare

  • Home Health Agency
  • Little Falls, MN
  • NPI 1952329047
  NPD

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1831142413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTCHER",
        "first_name": "ROGER",
        "middle_name": "MELVIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "28490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CLINICS",
            "identifier": "340G8BO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ISLE CLINIC",
            "identifier": "01-21114",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HILLMAN CLINIC",
            "identifier": "01-21117",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS HOSPITAL",
            "identifier": "340G9BO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA9090253011",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "109558",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA ONAMIA",
            "identifier": "01-21010",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206780300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Boschee Ree Armbrust
• Lola Marie Austin, LPN
• Clarise M Bassett, CNA
• Renee L. Bayerle, HHA
• Barbara Jean Bellamy, HHA
• Nicholas Allen Booker, DO
• Thomas Howard Bracken, M.D.
• Charil Kay Brausen, HHA
• Jeffrey Breer, M.S.W., L.I.C.S.W.
• Elaine Mary Byker, RN

• Family Medicine Physician in Onamia, MN
• Providers in Onamia, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.