Active NPI
Elisa K Boden, M.D.
- Gastroenterology Physician
- Seattle, WA
National Provider Identifier
1932167400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD201931
- Practice address
- 1100 9TH Ave
Buck Pavillion 3Rd Floor
Seattle, WA 98101-2756 - Phone
- (206) 223-2319
- NPI assigned
- May 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 226232 | MA | |
| Gastroenterology Physician | 207RG0100X | MD 60229173 | WA | |
| Gastroenterology Physician | 207RG0100X | 60 256098 | NY | |
| Gastroenterology Physician | 207RG0100X | MD201931 | OR | Primary |
Addresses
Primary practice location
1100 9TH Ave
Buck Pavillion 3Rd Floor
Seattle, WA 98101-2756
Mailing address
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-4373
Other practice location 1
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-4373
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932167400 | Other | WA | MONTANA DSHS |
| 0284291 | Other | WA | DEPT. OF LABOR AND INDUSTRIES |
| 1932167400 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- University of Chicago, Pritzker School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 59 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 66 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226232 | MA | MD | Internal Medicine Physician |
| 60 256098 | NY | MD | Gastroenterology Physician |
| MD 60229173 | WA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| Oregon Health & Science University | Past | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
Interoperability endpoints
- eboden133875@direct.ohsu.edu
- elisa.boden@direct.vmmc.org
Organizations & group practices 3
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
- Psychiatric Hospital
- Hillsboro, OR
- NPI 1073817714
-
- General Acute Care Hospital
- Hillsboro, OR
- NPI 1275591984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1932167400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-4373",
"fax_number": "503-418-4189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "BUCK PAVILLION 3RD FLOOR",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-223-2319"
}
],
"practiceLocations": [
{
"address_1": "3303 S Bond Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972394501",
"country_code": "US",
"telephone_number": "503-494-4373",
"fax_number": "503-418-4189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BODEN",
"first_name": "ELISA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "226232",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WA",
"license": "MD 60229173",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "60 256098",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OR",
"license": "MD201931",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MONTANA DSHS",
"identifier": "1932167400",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR AND INDUSTRIES",
"identifier": "0284291",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932167400",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.