Nicholas Boeder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-08893 Issued in NM

Practice address

1335 Gusdorf Road
Building E
Taos, NM 87571

Phone

(575) 758-0670

NPI assigned

Apr 1, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.85 of 100Reported as group

Quality

75.21

Promoting interoperability

100

Improvement activities

40

Cost

77.63

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.boeder.1@21279.direct.athenahealth.com
• Direct secure messaging: nicholas.boeder.1@30520.direct.athenahealth.com
• Direct secure messaging: nicholas.boeder.1@18545.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18545/brand/1/csg/1/fhir/r4

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.

• St Lukes Medical Clinic LLC

  • Internal Medicine Physician
  • Fort Collins, CO
  • NPI 1407953581

  CO

  Medicare reassignment NPD
• Nicholas Boeder - LCSW

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1427661164

  Clinical

  NPD Authorized official
• Human Resource Development Associates, Inc.

  • Mental Health Counselor
  • Taos, NM
  • NPI 1720206113
  NPD (past)
• Rapha Provider Agency LLC

  • Clinical Social Worker
  • Taos, NM
  • NPI 1588200984

  Clinical

  NPD (past)

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1851786446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437",
            "city": "EL PRADO",
            "state": "NM",
            "postal_code": "87529",
            "telephone_number": "575-770-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 GUSDORF ROAD",
            "address_2": "BUILDING E",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "575-758-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEDER",
        "first_name": "NICHOLAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-08893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Mountain Chiropractic Inc
• Joey Blue, LISW
• Bluebird, Inc.
• Kimberly A Boberschmidt, PHARMD
• Amber Bodhani, LPCC
• Emily Boeschenstein
• Sarah Bogar, CNM
• Charles Edward Bonfanti, PA
• Adrienne Bonosevich
• Matthew E Borrego, PHD, MS, RPH

• All providers in Taos, NM
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.