Blue Agave Functional Medicine Boerne PLLC
NPI 1235096447ActiveOrganization· General Practice· Boerne, TX
General Practice in Boerne, Texas, registered in NPPES in January 2026. The authorized official on file is Scott P. Knepper, MD, Medical Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1235096447 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 8, 2026 |
| Last updated in NPPES | Aug 13, 2026 |
| Certified by provider | Aug 13, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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