Individual provider Active NPI

Michael Keesey Boyd, M.D.

  • Surgery Physician
  • San Angelo, TX
National Provider Identifier
1124383567
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R5090 Issued in TX
Practice address
102 N Magdalen St
San Angelo, TX 76903-5400
Phone
(325) 747-2344
NPI assigned
Jul 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R5090 TX Primary

Addresses

Primary practice location

102 N Magdalen St
San Angelo, TX 76903-5400

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 747-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171201001647 TX Practitioner - General Surgery 1951529197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

2142 Sunset Dr
San Angelo, TX 76904-6829
Phone (325) 747-1511

220 E Harris Ave
San Angelo, TX 76903-5906
Phone (325) 747-1511

2626 N Bryant Blvd
San Angelo, TX 76903-2861
Phone (325) 747-1511

3501 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-7500

3502 Knickerbocker Rd
San Angelo, TX 76904-7671
Phone (325) 747-2222

3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 747-1511

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)25
Mastectomy22
Upper gastrointestinal (GI) endoscopy for acid reflux12
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R5090TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic Surgery CurrentSince Oct 4, 2020 Accepting new patients
Regional Employee Assistance Program Inc Surgery Current Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Nov 1, 2018 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Nov 1, 2018 Accepting new patients

Locations

2104 N Bedell Ave
Ste A
Del Rio, TX 78840
Phone (830) 703-1604

3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411

3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

102 N Magdalen St
San Angelo, TX 76903
Phone (325) 655-2200

3605 Executive Dr
San Angelo, TX 76904
Phone (325) 949-9555

3350 Executive Dr
San Angelo, TX 76904
Phone (325) 245-4504

Interoperability endpoints

  • Direct secure messaging: mboyd38914@shannonhealth.direct-ci.com

Organizations & group practices 4

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.

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1124383567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-747-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MAGDALEN ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035400",
            "telephone_number": "325-747-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "MICHAEL",
        "middle_name": "KEESEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "R5090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.