NPIMap

Individual provider Active NPI

Aglaia Kaissa De Boer, MD

  • Pulmonary Disease Physician
  • Palo Alto, CA
National Provider Identifier
1922421569
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A128593 Issued in CA
Practice address
300 Pasteur Dr
Palo Alto, CA 94304-2203
Phone
(650) 723-4000
NPI assigned
Feb 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A128593 CA
Pulmonary Disease Physician 207RP1001X A128593 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Palo Alto, CA 94304-2203

Mailing address

300 Pasteur Dr
Palo Alto, CA 94304-2203
Phone (650) 723-4000

Other practice location 1

505 Parnassus Ave
M-1090 Box 0111
San Francisco, CA 94143-0111
Phone (415) 702-5507

Other practice location 2

505 Parnassus Ave
M-1090 Box 0111
San Francisco, CA 94143-0111
Phone (415) 702-5507

Other names 1

  • Kaissa De Boer Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190709000196 CA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 6305171760 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A128593CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Jun 18, 2019 Accepting new patients
Stanford Health Care CurrentSince Jun 18, 2019 Accepting new patients
Stanford Health Care Internal Medicine Current Accepting new patients
Stanford Health Care Internal Medicine CurrentSince Jun 18, 2019 Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Palo Alto, CA 94304
Phone (650) 723-6469

505 Parnassus Ave
#M1090
San Francisco, CA 94143
Phone (415) 353-1043

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: adeboer244820@direct.stanfordhealthcare.org

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1922421569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042203",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042203",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Parnassus Ave",
            "address_2": "M-1090 Box 0111",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941430111",
            "country_code": "US",
            "telephone_number": "415-702-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 Parnassus Ave",
            "address_2": "M-1090 Box 0111",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941430111",
            "country_code": "US",
            "telephone_number": "415-702-5507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE BOER",
        "first_name": "AGLAIA",
        "middle_name": "KAISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-03",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A128593",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A128593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAISSA",
            "last_name": "DE BOER",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.