Individual provider Active NPI

Walter A Boyle III, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Mendocino, CA
National Provider Identifier
1093733727
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
G49981 Issued in CA
Practice address
44791 Baywood Dr
Mendocino, CA 95460-9527
Phone
(314) 324-3425
NPI assigned
Jul 18, 2006
Last updated
May 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 036.148697 IL
Critical Care Medicine (Anesthesiology) Physician 207LC0200X R6H50 MO
Critical Care Medicine (Anesthesiology) Physician 207LC0200X G49981 CA Primary

Addresses

Primary practice location

44791 Baywood Dr
Mendocino, CA 95460-9527

Mailing address

44791 Baywood Dr
Mendocino, CA 95460-9527
Phone (314) 324-3425

Other practice location 1

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110-1003
Phone (314) 362-6973

Other practice location 2

5147 Shaw Ave
Saint Louis, MO 63110-3039
Phone (314) 324-3425

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL
202577300MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240507000002 NC Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 0345382651 Reassigns benefits to 2 organizations
I20240703004031 CA Practitioner - Critical Care (Intensivists) 0345382651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
University of California, San Francisco School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
73.31
Promoting interoperability
92
Improvement activities
40
Cost
62

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G49981CAMDCritical Care Medicine (Anesthesiology) Physician
036.148697ILMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jan 10, 2026 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Aretaeus Telemedicine Inc. CurrentSince Apr 20, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Jun 10, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Jun 10, 2024 Accepting new patients

Locations

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

1 Madrone St
Willits, CA 95490
Phone (707) 456-3041

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

Interoperability endpoints

  • Direct secure messaging: wboyle163540@direct.carenet.org
  • Direct secure messaging: wboyle2888606@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1093733727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44791 BAYWOOD DR",
            "city": "MENDOCINO",
            "state": "CA",
            "postal_code": "954609527",
            "telephone_number": "314-324-3425",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44791 BAYWOOD DR",
            "city": "MENDOCINO",
            "state": "CA",
            "postal_code": "954609527",
            "telephone_number": "314-324-3425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "314-362-6973",
            "fax_number": "314-362-1185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5147 Shaw Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631103039",
            "country_code": "US",
            "telephone_number": "314-324-3425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "WALTER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "IL",
            "license": "036.148697",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MO",
            "license": "R6H50",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "CA",
            "license": "G49981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202577300",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendocino, CA

Sources for this page

Verify at the official NPI Registry.