RYAN JACOB BOETTGER DPM
NPI 1104492974
Podiatrist - Foot & Ankle Surgery in San Diego, CA
About Ryan Jacob Boettger Dpm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RYAN JACOB BOETTGER DPM (NPI 1104492974) is an individual foot & ankle surgery provider in San Diego, California, licensed in California (E6115) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ryan Jacob Boettger Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Ryan Boettger reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92103
- Reassigned Medicare billing, California enrollment
- 218 clinicians in this Medicare group
San Diego, CA 92108
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
San Diego, CA 92108
- Reassigned Medicare billing, California enrollment
- 4 clinicians in this Medicare group
San Diego, CA 92111
- Reassigned Medicare billing, California enrollment
- 1,233 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
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 Ryan Boettger's NPI number?
The NPI number for Ryan Boettger is 1104492974. It was assigned to this individual provider in the NPPES registry on June 1, 2021.
Where is Ryan Boettger located?
Ryan Boettger practices at 4077 Fifth Ave # Mer-35, San Diego, CA 92103. The listed phone number is (619) 260-7220.
What is Ryan Boettger's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Ryan Boettger enrolled in Medicare?
Yes. Ryan Boettger is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Ryan Boettger's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Boettger reassigns Medicare benefits to 4 organizations: On Call Specialists Medical Group Of San Diego, Inc. (San Diego, CA), Southern California Permanente Medical Group (San Diego, CA), San Diego Foot & Ankle, Inc (San Diego, CA) and Sharp Rees-Stealy Medical Group, Inc (San Diego, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ryan Boettger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ryan Boettger was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Ryan Jacob Boettger, DPM · NPI 1104492974
Foot & Ankle Surgery provider in San Diego, California. Individual provider, active in the CMS NPPES registry since June 1, 2021.
## Identity
- **NPI:** 1104492974 (Entity type: Individual)
- **Enumerated:** June 1, 2021
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **State license:** E6115 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4077 FIFTH AVE # MER-35, San Diego, CA 92103-2105
- **Phone:** (619) 260-7220
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): On Call Specialists Medical Group Of San Diego, Inc. (NPI 1962175836, San Diego, CA); Southern California Permanente Medical Group (NPI 1023425972, San Diego, CA); San Diego Foot & Ankle, Inc (NPI 1295249902, San Diego, CA); Sharp Rees-Stealy Medical Group, Inc (NPI 1285616177, San Diego, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1104492974) · Data from the CMS NPPES public registry.