Scott Robert Boerth (NPI# 1366439721, PAC ID# 7315041795) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1366439721 |
| PAC ID by PECOS | 7315041795 |
| Professional Enrollment ID | I20070323000274 |
| Full Name | Scott Robert Boerth |
| Organization Legal Name | LEWIS GALE PHYSICIANS LLC |
| Address |
133 Bostic Ln Pembroke VA 24136-3678 |
| Phone Number | 5408088913 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 6507886231 |
| Number of Group Practice Members | 176 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490110 | LEWISGALE HOSPITAL MONTGOMERY |
| 490042 | CARILION NEW RIVER VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 133 Bostic Ln, Pembroke, VA 24136-3678 | 5408088913 | LEWIS GALE PHYSICIANS LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | LEWIS GALE PHYSICIANS LLC |
| Physicians | 178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anita I Register | Obstetrics/gynecology | Lewis Gale Physicians LLC | 826 Davis St, Blacksburg, VA 24060-7010 |
| Brent M May | Physician Assistant | Lewis Gale Physicians LLC | 1902 Braeburn Dr, Salem, VA 24153-7304 |
| Vishalakshi K Sundaram | Family Medicine | Lewis Gale Physicians LLC | 4910 Valley View Nwblvd, Roanoke, VA 24012-2040 |
| Patrick William Kenney | Nurse Practitioner | Lewis Gale Physicians LLC | 1940 Braeburn Cir A, Salem, VA 24153-7388 |
| Cemil M Purut | Thoracic Surgery | Lewis Gale Physicians LLC | 1802 Braeburn Dr, Salem, VA 24153-7357 |
| Jessica Fultz | Nurse Practitioner | Lewis Gale Physicians LLC | 801 Davis St, Blacksburg, VA 24060-7008 |
| Jeremy Smalley | Orthopedic Surgery | Lewis Gale Physicians LLC | 400 Scruggs Rd, Suite 2300, Moneta, VA 24121-2683 |
| Teri Pa-c Mccormick-goodha | Physician Assistant | Lewis Gale Physicians LLC | 4550 Lee Hwy, Suite B, Dublin, VA 24084-3820 |
| Kathryn C Hoyt | Physician Assistant | Lewis Gale Physicians LLC | 101 Knotbreak Rd, Salem, VA 24153-5404 |
| Casey R Bowles | Physician Assistant | Lewis Gale Physicians LLC | 4615 Huntridge Rd, Roanoke, VA 24012-8510 |
| Street Address |
133 BOSTIC LN |
| City | PEMBROKE |
| State | VA |
| Zip | 24136-3678 |
| City | PEMBROKE |
| Zip Code | 24136 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | PEMBROKE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Scott Robert Boerth.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.