NPIMap

Individual provider Active NPI

Jackson Wyatt Boice, MD

  • Diagnostic Radiology Physician
  • Lenexa, KS
National Provider Identifier
1104319664
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2023006970 Issued in MO
Practice address
9040 Quivira Rd
Lenexa, KS 66215-3902
Phone
(913) 261-3109
NPI assigned
Jun 10, 2018
Last updated
Aug 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2023006970 MO Primary

Addresses

Primary practice location

9040 Quivira Rd
Lenexa, KS 66215-3902

Mailing address

9040 Quivira Rd
Lenexa, KS 66215-3902
Phone (913) 261-3109

Other practice location 1

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone (314) 362-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230618000141 MO Practitioner - Diagnostic Radiology 6002164548 Reassigns benefits to 10 organizations
I20240725000271 KS Practitioner - Diagnostic Radiology 6002164548 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll County Memorial HospitalGroup PAC ID 2860485638, 64 clinicians
Excelsior Springs City HospitalGroup PAC ID 7315847209, 39 clinicians
United Imaging Consultants LLCGroup PAC ID 4486545498, 33 clinicians

Practice addresses (Care Compare)

1502 N Jefferson St
Carrollton, MO 64633-1948
Phone (660) 542-1695

1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone (816) 630-6081

2100 Baptiste Dr
Paola, KS 66071-1314
Phone (913) 294-2327

2100 SE Blue Pkwy
Lee's Summit, MO 64063-1007
Phone (816) 282-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.76 of 100Reported as group
Quality
46.12
Promoting interoperability
100
Improvement activities
40
Cost
53.08

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
88.62
Improvement activities
40
Cost
77.86

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Miracl, LLC CurrentSince Jul 1, 2023 Accepting new patients
Ray County Memorial Hospital CurrentSince Apr 24, 2025 Accepting new patients
Excelsior Springs City Hospital CurrentSince Dec 1, 2024 Accepting new patients
Excelsior Springs City Hospital Current Accepting new patients
Carroll County Memorial Hospital CurrentSince Jun 1, 2024 Accepting new patients
United Imaging Consultants, LLC Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients

Locations

20333 W 151st St
Olathe, KS 66061
Phone (888) 960-1393

2100 Baptiste Dr
Paola, KS 66071
Phone (913) 294-2327

9040 Quivira Rd
Shawnee Msn, KS 66215
Phone (913) 492-9675

1502 N Jefferson St
Carrollton, MO 64633
Phone (660) 542-1695

1700 Rainbow Blvd
Exclsor Sprgs, MO 64024

2800 E Rock Haven Rd
Harrisonville, MO 64701
Phone (816) 380-3474

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

904 Wollard Blvd
Richmond, MO 64085
Phone (816) 470-5432

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

Interoperability endpoints

  • Direct secure messaging: jboice755529@direct.kuha.org

Organizations & group practices 10

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 5

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": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1104319664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 QUIVIRA RD",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662153902",
            "telephone_number": "913-261-3109",
            "fax_number": "314-747-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 QUIVIRA RD",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662153902",
            "telephone_number": "913-261-3109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101016",
            "country_code": "US",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOICE",
        "first_name": "JACKSON",
        "middle_name": "WYATT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-10",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2023006970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

Verify at the official NPI Registry.