Avery B Boardman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000896 Issued in PA

Practice address

889 Craftmaster Road
Wysox, PA 18854-0000

Phone

(570) 265-3668

Fax

(570) 265-8936

NPI assigned

Oct 13, 2006

Last updated

Mar 23, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grady D. Gafford MD PCGroup PAC ID 0042258048, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Merit-based Incentive Payment System (MIPS)

Final score

60 of 100Reported as group

Quality

20

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grady D. Gafford MD PC

  • Ophthalmology Physician
  • Wellsboro, PA
  • NPI 1184635286

  Optometrist

  Medicare reassignment Care Compare group NPD
• Boardman Family Eye Care PC

  • Optometrist
  • Wysox, PA
  • NPI 1366627275
  Authorized official Same address or phone
• Grady D. Gafford MD PC

  dba Boardman Family EyeCare

  • Optometrist
  • Towanda, PA
  • NPI 1942876917
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  dba Robert Packer Hospital, Towanda Campus

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1073603718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 CRAFTMASTER ROAD",
            "address_2": "PO BOX 331",
            "city": "WYSOX",
            "state": "PA",
            "postal_code": "188540000",
            "telephone_number": "570-265-3668",
            "fax_number": "570-265-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 CRAFTMASTER ROAD",
            "city": "WYSOX",
            "state": "PA",
            "postal_code": "188540000",
            "telephone_number": "570-265-3668",
            "fax_number": "570-265-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "AVERY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012690190004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boardman Family Eye Care PC
• Ronald Dean
• Peter A Ferrulli, MA CCC SLP
• Thomas Masker, DC
• Erin Middendorf, RN
• Mindfulness Counseling Center LLC

• Optometrist in Wysox, PA
• Providers in Wysox, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.