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DR. KEITH G BOMAN M.D.
NPI 1093719338
Specialist in Las Vegas, NV

Active since June 01, 2005PECOS Enrolled
601 S RANCHO DR, STE. D-28, LAS VEGAS, NV 89106(702) 383-0677(702) 383-0688 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2023, Feb 3, 2017 (2 updates tracked since 2017).

About Dr. Keith G Boman M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEITH G BOMAN M.D. (NPI 1093719338) is an individual specialist in Las Vegas, Nevada, licensed in Nevada (NV4089) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093719338
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. KEITH G BOMANCredential: M.D.
Location Address601 S RANCHO DR, STE. D-28Las Vegas, NV 89106-4899
Mailing Address9260 W. Sunset Rd, Ste200Las Vegas, NV 89148-4903 · (702) 255-3547 · Fax (702) 921-2419
Phone(702) 383-0677
Fax(702) 383-0688
Sole ProprietorNo
Enumeration DateJune 1, 2005
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1093719338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NV · NV4089
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
601 S RANCHO DR, Las Vegas, NV 89106
Open in Google Maps ↗

Other Identifiers 2

Medicaid002002951NV
OtherNV 2996NV · Bc/bs Indentifier

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keith G Boman M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY DUNGEY
Social Worker
601 S RANCHO DR
LAS VEGAS, NV 89106
Clark County (702) 437-4673
GENLAB INC
Clinical Medical Laboratory
601 S RANCHO DR, SUITE A4
LAS VEGAS, NV 89106
Clark County (702) 385-4522
DR. EDMUND REX PASIMIO M.D.
Physical Medicine & Rehabilitation
601 S RANCHO DR, SUITE #A-6
LAS VEGAS, NV 89106
Clark County (702) 386-0909
THRESHOLDS HOSPICE OF NEVADA LLC
Hospice Care, Community Based
601 S RANCHO DR, STE A-6
LAS VEGAS, NV 89106
Clark County (702) 767-2469
EDDIEPMD INC
Physical Medicine & Rehabilitation
601 S RANCHO DR, STE A-6
LAS VEGAS, NV 89106
Clark County (702) 386-0909
NEVADA RETINA ASSOCIATES LV
Ophthalmology
601 S RANCHO DR, SUITE 31 D
LAS VEGAS, NV 89106
Clark County (702) 382-3937
ADVANCED NEURODIAGNOSTICS, LLC
Clinic/Center (Sleep Disorder Diagnostic)
601 S RANCHO DR, SUITE A-4
LAS VEGAS, NV 89106
Clark County (702) 258-3315
DR. EDWARD PAUL RUGGEROLI DDS
Dentist (General Practice)
601 S RANCHO DR, SUITE A-3
LAS VEGAS, NV 89106
Clark County (702) 382-2311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Boman's NPI number?

The NPI number for Keith Boman is 1093719338. It was assigned to this individual provider in the NPPES registry on June 1, 2005.

Where is Keith Boman located?

Keith Boman practices at 601 S Rancho Dr Ste. D-28, Las Vegas, NV 89106. The listed phone number is (702) 383-0677.

What is Keith Boman's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Keith Boman enrolled in Medicare?

Yes. Keith Boman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Keith Boman was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.