David Antuane Boston, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

006062 Issued in GA

Practice address

960 Johnson Ferry Rd
Ste 500
Atlanta, GA 30342-1631

Phone

(404) 257-0006

Fax

(404) 851-1316

NPI assigned

May 18, 2011

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment Care Compare group NPD
• Piedmont Specialty Hospital Billing LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1699290510
  Medicare reassignment Care Compare group
• Piedmont Healthcare Inc

  • Cardiovascular Disease Physician
  • Stockbridge, GA
  • NPI 1376624940
  Medicare reassignment
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment

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

• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1083907463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD",
            "address_2": "STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-257-0006",
            "fax_number": "404-851-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD",
            "address_2": "STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-257-0006",
            "fax_number": "404-851-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "DAVID",
        "middle_name": "ANTUANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003151170A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PCCA@PC8.gadirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "960 Johnson Ferry Rd",
            "address_2": "Ste 500",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley A Bostic
• Elizabeth Ann Bostick, RN
• Joy Lashunda Bostick
• Rita Thetford Bostick, MA, LPC
• Roberd Maner Bostick, M.D.
• Naja Alana Bostwick
• Elizabeth Boswell, M.D.
• Vincent Everett Boswell, M.D., P.C.
• Rachel Susan Botbyl, MD
• Maame Tekyiwa Botchway, MD, MPH

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.