DR. MICHAEL DOUGLAS BOEHM (NPI# 1912984360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912984360 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DOUGLAS BOEHM |
| Credential | MD |
| Practice Address |
2001 5th St Suite 49 Eye Surgeons Associates PC Silvis IL 61282 |
| Mailing Address |
777 Tanglefoot Ln Eye Surgeons Associates PC Bettendorf IA 52722-1650 |
| Practice Telephone | 3097922020 |
| Practice Fax Number | 3097924753 |
| Mailing Telephone | 5633232020 |
| Mailing Fax Number | 5633285694 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2018-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 35141 | IA | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 036-109140 | IL | Allopathic & Osteopathic Physicians |
| N | 207WX0120X |
Ophthalmology Specialization: Cornea and External Diseases Specialist |
35141 | IA | Allopathic & Osteopathic Physicians |
| N | 207WX0120X |
Ophthalmology Specialization: Cornea and External Diseases Specialist |
036-109140 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | IA GROUP MEDICAID # | 0060350 | 01 |
| IL | 036109146 | 05 | |
| IA | IA GROUP MEDICARE # | 26568 | 01 |
| IL | IL GROUP MEDICARE # | 790930 | 01 |
| IA | 0290627 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750588463 | Michael Edward Boehm | Psychologist | 189 33rd St, Brooklyn, NY 11232-2109 | 2007-06-27 |
| 1356651277 | Michael Edward Boehm | Dentist | 1280 E Polston Ave, Post Falls, ID 83854-6056 | 2010-10-13 |
| 1205000494 | Michael Edward Boehm | Counselor | 1707 Main St, La Crosse, WI 54601-4200 | 2008-04-17 |
| 1750300141 | Michael D Boehm | Internal Medicine | 300 W Hospital Rd, Meb Section, Fort Gordon, GA 30905-5741 | 2006-07-18 |
| Street Address |
2001 5TH ST SUITE 49 EYE SURGEONS ASSOCIATES PC |
| City | SILVIS |
| State | IL |
| Zip Code | 61282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861494114 | Priscilla Perry Arnold | Ophthalmology | 2001 5th St, Suite 49, Silvis, IL 61282-2903 | 2005-06-01 |
| 1194326017 | Paul Garner | Pharmacist | 2001 5th St, Silvis, IL 61282 | 2020-11-06 |
| 1578993135 | Lindsey Brost | Dietitian, Registered | 2001 5th St, Suite 51, Silvis, IL 61282-2903 | 2013-11-19 |
| 1639456411 | Katherine Loretta Murphy Dunne | Optometrist | 2001 5th St, Suite 49, Silvis, IL 61282-2903 | 2011-11-08 |
| 1023319365 | Nicolle Jeanette Putnam | Dietitian, Registered | 2001 5th St, Suite 51, Silvis, IL 61282-2903 | 2010-11-03 |
| 1962522557 | Cory Anton Debuhr | Pharmacist | 2001 5th St, Silvis, IL 61282-2903 | 2007-03-29 |
| 1477672525 | Christie Lea Mcmann | Pharmacist | 2001 5th St, Silvis, IL 61282-2903 | 2007-03-28 |
| 1275562092 | Hy Vee Inc | Durable Medical Equipment & Medical Supplies | 2001 5th St, Silvis, IL 61282-2903 | 2006-07-02 |
| 1003893454 | Nikhil Sudhakar Wagle | Ophthalmology | 2001 5th St, Suite 49, Silvis, IL 61282 | 2005-12-28 |
| 1477530830 | James Guy Wymore | Ophthalmology | 2001 5th St, Suite 49, Silvis, IL 61282-2903 | 2005-12-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172605 | Phyllis Cunningham | Technician | 603 2nd Ave C, Silvis, IL 61282 | 2019-09-07 |
| 1710369400 | Krystle Lee Hergert | Dietitian, Registered | 2001 5th Street, Silvis, IL 61282 | 2015-06-18 |
| 1558549469 | Bobb Chiropractic Center P.C. | Chiropractor | 813 1st Avenue, Silvis, IL 61282 | 2008-02-01 |
| 1952509846 | Jennifer Marie Jensen | Pharmacist | 1601 18th St, Silvis, IL 61282 | 2007-07-03 |
| 1871516781 | Joseph R Yates | Emergency Medicine | 801 Illini Drive, Silvis, IL 61282 | 2006-07-25 |
| 1376581447 | Holly S Wilkinson | Physical Therapist | 902 Illini Drive, Silvis, IL 61282 | 2006-06-02 |
| 1831145507 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 1312 John Deere Expy, Silvis, IL 61282 | 2006-05-25 |
| 1366043291 | Karen Marie Garner | Pharmacist | 2001 5th Street, Silvis, IL 61282 | 2020-11-06 |
| 1659865848 | Njl Chiropractic | Clinic/Center | 813 1st Ave, Silvis, IL 61282 | 2018-06-20 |
| 1376922930 | Muhammad Kumail Shah | Family Medicine | 801 Illini Dr, Silvis, IL 61282 | 2015-05-28 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861494114 | Priscilla Perry Arnold | Ophthalmology | 2001 5th St, Suite 49, Silvis, IL 61282-2903 | 2005-06-01 |
| 1205806197 | Chiradej Napawan | Ophthalmology | 855 Illini Dr, Suite 201, Silvis, IL 61282-2907 | 2006-01-24 |
| 1003893454 | Nikhil Sudhakar Wagle | Ophthalmology | 2001 5th St, Suite 49, Silvis, IL 61282 | 2005-12-28 |
| 1477530830 | James Guy Wymore | Ophthalmology | 2001 5th St, Suite 49, Silvis, IL 61282-2903 | 2005-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433473 | Chicagoland Eye Consultants, Sc | Ophthalmology | 477 E Butterfield Rd Ste 101, Lombard, IL 60148-4880 | 2020-09-30 |
| 1649894189 | Lakeshore Ophthalmology, LLC | Ophthalmology | 2525 S Michigan Ave Fl 8, Chicago, IL 60616-2315 | 2020-06-01 |
| 1053940460 | Neil L Ross | Ophthalmology | 950 N Michigan Ave Apt 5403, Chicago, IL 60611-7535 | 2020-04-07 |
| 1932730256 | Cereesa E. Longest Md Sc | Ophthalmology | 225 Oak Knoll Rd, Barrington, IL 60010-2615 | 2020-01-27 |
| 1497314181 | Ophthalmology Surgery Center of Illinois, LLC | Ophthalmology | 1300 N Arlington Heights Rd Ste 150, Itasca, IL 60143-3128 | 2019-06-06 |
| 1770149049 | Rop Consultants LLC | Ophthalmology | 5228 N Virginia Ave, Chicago, IL 60625-4015 | 2019-05-13 |
| 1962969881 | Monique Munro | Ophthalmology | 1855 W Taylor Street. Suite 3138 Illinois Eye and Infir, Chicago, IL 60612 | 2019-02-27 |
| 1679039457 | Laser and Cataract Institute, LLC | Ophthalmology | 22200 Wolf Rd, Frankfort, IL 60423-7721 | 2019-02-15 |
| 1063987345 | Chataam Optical LLC | Ophthalmology | 8741 S Greenwood Ave Ste 108, Chicago, IL 60619-7058 | 2018-10-12 |
| 1922507474 | Dekalb Eye Consultants, LLC | Ophthalmology | 1075 Featherstone Rd Ste 10, Rockford, IL 61107-5906 | 2018-02-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.