Brenda Joann Boetger, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP021155 Issued in PA

Practice address

1910 Sassafras St Ste 200
Erie, PA 16502-2716

Phone

(814) 452-7879

Fax

(814) 455-2628

NPI assigned

Dec 22, 2019

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, FL2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Truhealth of Pennsylvania LLCGroup PAC ID 3173051117, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Truhealth of Pennsylvania LLC

  • Nurse Practitioner
  • Erie, PA
  • NPI 1114741634
  Medicare reassignment Care Compare group NPD
• Wellbe Senior Medical Group of Pennsylvania PC

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1255089132
  Medicare reassignment NPD

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

{
    "created_epoch": "1576972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1861031825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716",
            "telephone_number": "814-452-7879",
            "fax_number": "814-455-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716",
            "telephone_number": "814-452-7879",
            "fax_number": "814-455-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETGER",
        "first_name": "BRENDA",
        "middle_name": "JOANN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-22",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021155",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "PA",
            "license": "SP021155",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bboetger274701@direct.ahn.org",
            "affiliation": "N",
            "address_1": "1910 Sassafras St Ste 200",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165022716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Rose Blount, CRNP
• Edward Arthur Blounts Jr., D.O.
• Nora Celia Blue, MSW
• Brian P. Boam, CTRS
• Kayleen Boeckenhauer
• John Boetger, LCSW
• Jose Luis Boggio, MD
• Chyna Bohman, OTR/L
• Rebecca L Bohman, CPS
• Ashleigh Elizabeth Boise

• Nurse Practitioner in Erie, PA
• Providers in Erie, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.