Active NPI
Stephanie Anne Boyarsky, MD
- Family Medicine Physician
- Scranton, PA
National Provider Identifier
1124080247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD042647L
- Practice address
- 1789 N Keyser Ave
Scranton, PA 18508-1250 - Phone
- (570) 969-1904
- Fax
- (570) 207-5314
- NPI assigned
- Apr 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD042647L | PA | Primary |
Addresses
Primary practice location
1789 N Keyser Ave
Scranton, PA 18508-1250
Mailing address
1789 N Keyser Ave
Scranton, PA 18508-1250
Phone (570) 969-1904
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0461081000 | Other | PABLUE CROSS | |
| 080070777 | Other | RAILROADMEDICARE | |
| 631143 | Other | FIRST PRIORITY LIFE | |
| 001468 | Other | FIRST PRIORITY HEALTH HMO | |
| 001290633 | Other | UNITED | |
| 2Y2168 | Other | HEALTH AMERICA | |
| 27539 E475 | Other | GGOLD | |
| 27539 E475 | Other | GHP | |
| 631143 | Other | PA BLUE SHIELD | |
| 536762 | Other | AETNA | |
| 0012220210002 | Medicaid | PA | |
| 0461081000 | Other | BPC | |
| 27539 E475 | Other | GEISINGER HEALTH/990LD 9H | |
| E59863 | Other | STERLING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD042647L | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268179200000",
"number": "1124080247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1789 N KEYSER AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185081250",
"telephone_number": "570-969-1904",
"fax_number": "570-207-5314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1789 N KEYSER AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185081250",
"telephone_number": "570-969-1904",
"fax_number": "570-207-5314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYARSKY",
"first_name": "STEPHANIE",
"middle_name": "ANNE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-04",
"last_updated": "2010-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD042647L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PABLUE CROSS",
"identifier": "0461081000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROADMEDICARE",
"identifier": "080070777",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY LIFE",
"identifier": "631143",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH HMO",
"identifier": "001468",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "001290633",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "2Y2168",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GGOLD",
"identifier": "27539 E475",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "27539 E475",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA BLUE SHIELD",
"identifier": "631143",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "536762",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0012220210002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BPC",
"identifier": "0461081000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH/990LD 9H",
"identifier": "27539 E475",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STERLING",
"identifier": "E59863",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.