Active NPI
Maurice Boss
- Licensed Practical Nurse
- Portland, OR
National Provider Identifier
1912439084
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jan 20, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 201130606LPN
- Practice address
- 6601 NE 78TH CT
Suite A3
Portland, OR 97218-2823 - Phone
- (503) 252-3949
- NPI assigned
- Mar 29, 2017
- Last updated
- Mar 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201130606LPN | OR | Primary |
Addresses
Primary practice location
6601 NE 78TH CT
Suite A3
Portland, OR 97218-2823
Mailing address
6601 NE 78TH CT
Suite A3
Portland, OR 97218-2823
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201130606LPN | OR | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1912439084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 NE 78TH CT",
"address_2": "SUITE A3",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972182823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 NE 78TH CT",
"address_2": "SUITE A3",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972182823",
"telephone_number": "503-252-3949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSS",
"first_name": "MAURICE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-29",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OR",
"license": "201130606LPN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.