NPIMap

Organization Active NPI

Ian Boykin MD PA

  • Internal Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1174711162
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME80735 Issued in FL
Legal business name
IAN BOYKIN MD PA
Practice address
2000 Nebraska Ave
Fort Pierce, FL 34950-4833
Phone
(772) 465-4444
Fax
(772) 466-4499
NPI assigned
Oct 4, 2007
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Cassie Boykin, RN
Title
Practice Manager
Phone
(772) 465-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME80735 FL Primary

Addresses

Primary practice location

2000 Nebraska Ave
Fort Pierce, FL 34950-4833

Mailing address

2000 Nebraska Ave
Fort Pierce, FL 34950-4833
Phone (772) 465-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100805000225 FL Part B Supplier - Clinic/Group Practice 5092848440 Receives reassigned benefits from 11 practitioners
Practice locations: Ft Pierce, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1054473Ian C Boykin MD2000 Nebraska Ave, Fort Pierce, FL 34950Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1174711162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NEBRASKA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504833",
            "telephone_number": "772-465-4444",
            "fax_number": "772-466-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NEBRASKA AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504833",
            "telephone_number": "772-465-4444",
            "fax_number": "772-466-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAN BOYKIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "BOYKIN",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "772-465-4444",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME80735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.